Outcome of childhood acute lymphoblastic leukemia with induction failure treated by the Japan Association of Childhood Leukemia Study (JACLS) ALL F-protocol

Nobuhiro Suzuki, Keiko Yumura-Yagi, Makoto Yoshida, Junichi Hara, Shinichiro Nishimura, Tooru Kudoh, Akio Tawa, Ikuya Usami, Akihiko Tanizawa, Hiroki Hori, Yasuhiko Ito, Ryosuke Miyaji, Megumi Oda, Koji Kato, Kazuko Hamamoto, Yuko Osugi, Yoshiko Hashii, Tatsutoshi Nakahata, Keizo Horibe

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background. Children with acute lymphoblastic leukemia (ALL) who fail to achieve complete remission (CR) after induction therapy (induction failure: IF) have a poor prognosis; however, there have been few prospective studies in patients with IF. Patients and Methods. Between April 1997 and March 2005, 27 of 1,237 leukemic patients (2.2%) failed to achieve CR after four- or five-drug induction therapy. Twenty-three of these patients entered the F-protocol study, which mainly consisted of acute-myeloid-leukemia-oriented chemotherapy followed by scheduled hematopoietic cell transplantation (HCT). Results. Seventeen (73.9%) of the 23 patients responded to re-induction chemotherapy with CR. Of note, 15 (93.8%) of 16 patients with Philadelphia-chromosome-negative (non-Ph+) ALL achieved CR; in contrast, only 2 (28.6%) of 7 Ph + patients achieved CR. Fourteen (82.4%) of 17 patients remained in CR (CCR) until their scheduled HCT, 12 of the 14 with CCR underwent HCT as scheduled, and 6 patients remain in first CR after a median of 78 months (range, 49-107 months). The 5-year overall survival (OS) rates of 16 patients with non-Ph+ and 7 patients with Ph+ were 43.8±12.4% and 14.3±13.2%, respectively (P=0.012). The 5-year OS rate of the 17 patients who obtained CR by re-induction therapy and the 6 who did not were 47.1±12.1% and 0%, respectively (P<0.001). Conclusion. Acute-myeloid-leukemia-oriented chemotherapy followed by scheduled HCT is a promising treatment strategy for non-Ph+ ALL patients with IF.

Original languageEnglish
Pages (from-to)71-78
Number of pages8
JournalPediatric Blood and Cancer
Volume54
Issue number1
DOIs
Publication statusPublished - Jan 1 2010
Externally publishedYes

Fingerprint

Precursor Cell Lymphoblastic Leukemia-Lymphoma
Japan
Leukemia
Cell Transplantation
Remission Induction
Acute Myeloid Leukemia
Drug Therapy
Survival Rate
Philadelphia Chromosome
Induction Chemotherapy
Therapeutics
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Outcome of childhood acute lymphoblastic leukemia with induction failure treated by the Japan Association of Childhood Leukemia Study (JACLS) ALL F-protocol. / Suzuki, Nobuhiro; Yumura-Yagi, Keiko; Yoshida, Makoto; Hara, Junichi; Nishimura, Shinichiro; Kudoh, Tooru; Tawa, Akio; Usami, Ikuya; Tanizawa, Akihiko; Hori, Hiroki; Ito, Yasuhiko; Miyaji, Ryosuke; Oda, Megumi; Kato, Koji; Hamamoto, Kazuko; Osugi, Yuko; Hashii, Yoshiko; Nakahata, Tatsutoshi; Horibe, Keizo.

In: Pediatric Blood and Cancer, Vol. 54, No. 1, 01.01.2010, p. 71-78.

Research output: Contribution to journalArticle

Suzuki, N, Yumura-Yagi, K, Yoshida, M, Hara, J, Nishimura, S, Kudoh, T, Tawa, A, Usami, I, Tanizawa, A, Hori, H, Ito, Y, Miyaji, R, Oda, M, Kato, K, Hamamoto, K, Osugi, Y, Hashii, Y, Nakahata, T & Horibe, K 2010, 'Outcome of childhood acute lymphoblastic leukemia with induction failure treated by the Japan Association of Childhood Leukemia Study (JACLS) ALL F-protocol', Pediatric Blood and Cancer, vol. 54, no. 1, pp. 71-78. https://doi.org/10.1002/pbc.22217
Suzuki, Nobuhiro ; Yumura-Yagi, Keiko ; Yoshida, Makoto ; Hara, Junichi ; Nishimura, Shinichiro ; Kudoh, Tooru ; Tawa, Akio ; Usami, Ikuya ; Tanizawa, Akihiko ; Hori, Hiroki ; Ito, Yasuhiko ; Miyaji, Ryosuke ; Oda, Megumi ; Kato, Koji ; Hamamoto, Kazuko ; Osugi, Yuko ; Hashii, Yoshiko ; Nakahata, Tatsutoshi ; Horibe, Keizo. / Outcome of childhood acute lymphoblastic leukemia with induction failure treated by the Japan Association of Childhood Leukemia Study (JACLS) ALL F-protocol. In: Pediatric Blood and Cancer. 2010 ; Vol. 54, No. 1. pp. 71-78.
@article{7079825dd8694c11bbef39d8e2c4f2d0,
title = "Outcome of childhood acute lymphoblastic leukemia with induction failure treated by the Japan Association of Childhood Leukemia Study (JACLS) ALL F-protocol",
abstract = "Background. Children with acute lymphoblastic leukemia (ALL) who fail to achieve complete remission (CR) after induction therapy (induction failure: IF) have a poor prognosis; however, there have been few prospective studies in patients with IF. Patients and Methods. Between April 1997 and March 2005, 27 of 1,237 leukemic patients (2.2{\%}) failed to achieve CR after four- or five-drug induction therapy. Twenty-three of these patients entered the F-protocol study, which mainly consisted of acute-myeloid-leukemia-oriented chemotherapy followed by scheduled hematopoietic cell transplantation (HCT). Results. Seventeen (73.9{\%}) of the 23 patients responded to re-induction chemotherapy with CR. Of note, 15 (93.8{\%}) of 16 patients with Philadelphia-chromosome-negative (non-Ph+) ALL achieved CR; in contrast, only 2 (28.6{\%}) of 7 Ph + patients achieved CR. Fourteen (82.4{\%}) of 17 patients remained in CR (CCR) until their scheduled HCT, 12 of the 14 with CCR underwent HCT as scheduled, and 6 patients remain in first CR after a median of 78 months (range, 49-107 months). The 5-year overall survival (OS) rates of 16 patients with non-Ph+ and 7 patients with Ph+ were 43.8±12.4{\%} and 14.3±13.2{\%}, respectively (P=0.012). The 5-year OS rate of the 17 patients who obtained CR by re-induction therapy and the 6 who did not were 47.1±12.1{\%} and 0{\%}, respectively (P<0.001). Conclusion. Acute-myeloid-leukemia-oriented chemotherapy followed by scheduled HCT is a promising treatment strategy for non-Ph+ ALL patients with IF.",
author = "Nobuhiro Suzuki and Keiko Yumura-Yagi and Makoto Yoshida and Junichi Hara and Shinichiro Nishimura and Tooru Kudoh and Akio Tawa and Ikuya Usami and Akihiko Tanizawa and Hiroki Hori and Yasuhiko Ito and Ryosuke Miyaji and Megumi Oda and Koji Kato and Kazuko Hamamoto and Yuko Osugi and Yoshiko Hashii and Tatsutoshi Nakahata and Keizo Horibe",
year = "2010",
month = "1",
day = "1",
doi = "10.1002/pbc.22217",
language = "English",
volume = "54",
pages = "71--78",
journal = "Pediatric Blood and Cancer",
issn = "1545-5009",
publisher = "Wiley-Liss Inc.",
number = "1",

}

TY - JOUR

T1 - Outcome of childhood acute lymphoblastic leukemia with induction failure treated by the Japan Association of Childhood Leukemia Study (JACLS) ALL F-protocol

AU - Suzuki, Nobuhiro

AU - Yumura-Yagi, Keiko

AU - Yoshida, Makoto

AU - Hara, Junichi

AU - Nishimura, Shinichiro

AU - Kudoh, Tooru

AU - Tawa, Akio

AU - Usami, Ikuya

AU - Tanizawa, Akihiko

AU - Hori, Hiroki

AU - Ito, Yasuhiko

AU - Miyaji, Ryosuke

AU - Oda, Megumi

AU - Kato, Koji

AU - Hamamoto, Kazuko

AU - Osugi, Yuko

AU - Hashii, Yoshiko

AU - Nakahata, Tatsutoshi

AU - Horibe, Keizo

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Background. Children with acute lymphoblastic leukemia (ALL) who fail to achieve complete remission (CR) after induction therapy (induction failure: IF) have a poor prognosis; however, there have been few prospective studies in patients with IF. Patients and Methods. Between April 1997 and March 2005, 27 of 1,237 leukemic patients (2.2%) failed to achieve CR after four- or five-drug induction therapy. Twenty-three of these patients entered the F-protocol study, which mainly consisted of acute-myeloid-leukemia-oriented chemotherapy followed by scheduled hematopoietic cell transplantation (HCT). Results. Seventeen (73.9%) of the 23 patients responded to re-induction chemotherapy with CR. Of note, 15 (93.8%) of 16 patients with Philadelphia-chromosome-negative (non-Ph+) ALL achieved CR; in contrast, only 2 (28.6%) of 7 Ph + patients achieved CR. Fourteen (82.4%) of 17 patients remained in CR (CCR) until their scheduled HCT, 12 of the 14 with CCR underwent HCT as scheduled, and 6 patients remain in first CR after a median of 78 months (range, 49-107 months). The 5-year overall survival (OS) rates of 16 patients with non-Ph+ and 7 patients with Ph+ were 43.8±12.4% and 14.3±13.2%, respectively (P=0.012). The 5-year OS rate of the 17 patients who obtained CR by re-induction therapy and the 6 who did not were 47.1±12.1% and 0%, respectively (P<0.001). Conclusion. Acute-myeloid-leukemia-oriented chemotherapy followed by scheduled HCT is a promising treatment strategy for non-Ph+ ALL patients with IF.

AB - Background. Children with acute lymphoblastic leukemia (ALL) who fail to achieve complete remission (CR) after induction therapy (induction failure: IF) have a poor prognosis; however, there have been few prospective studies in patients with IF. Patients and Methods. Between April 1997 and March 2005, 27 of 1,237 leukemic patients (2.2%) failed to achieve CR after four- or five-drug induction therapy. Twenty-three of these patients entered the F-protocol study, which mainly consisted of acute-myeloid-leukemia-oriented chemotherapy followed by scheduled hematopoietic cell transplantation (HCT). Results. Seventeen (73.9%) of the 23 patients responded to re-induction chemotherapy with CR. Of note, 15 (93.8%) of 16 patients with Philadelphia-chromosome-negative (non-Ph+) ALL achieved CR; in contrast, only 2 (28.6%) of 7 Ph + patients achieved CR. Fourteen (82.4%) of 17 patients remained in CR (CCR) until their scheduled HCT, 12 of the 14 with CCR underwent HCT as scheduled, and 6 patients remain in first CR after a median of 78 months (range, 49-107 months). The 5-year overall survival (OS) rates of 16 patients with non-Ph+ and 7 patients with Ph+ were 43.8±12.4% and 14.3±13.2%, respectively (P=0.012). The 5-year OS rate of the 17 patients who obtained CR by re-induction therapy and the 6 who did not were 47.1±12.1% and 0%, respectively (P<0.001). Conclusion. Acute-myeloid-leukemia-oriented chemotherapy followed by scheduled HCT is a promising treatment strategy for non-Ph+ ALL patients with IF.

UR - http://www.scopus.com/inward/record.url?scp=73349127050&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73349127050&partnerID=8YFLogxK

U2 - 10.1002/pbc.22217

DO - 10.1002/pbc.22217

M3 - Article

C2 - 19813250

AN - SCOPUS:73349127050

VL - 54

SP - 71

EP - 78

JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

SN - 1545-5009

IS - 1

ER -