Low incidence of osteonecrosis in childhood acute lymphoblastic leukemia treated with ALL-97 and ALL-02 study of Japan association of childhood leukemia study group

Kenichi Sakamoto, Toshihiko Imamura, Kentaro Kihira, Koji Suzuki, Hisashi Ishida, Hiromi Morita, Miyako Kanno, Takeshi Mori, Hidefumi Hiramatsu, Kousaku Matsubara, Kiminori Terui, Yoshihiro Takahashi, So Ichi Suenobu, Daiichiro Hasegawa, Yoshiyuki Kosaka, Koji Kato, Akiko Moriya-Saito, Atsushi Sato, Hirohide Kawasaki, Keiko Yumura-YagiJunichi Hara, Hiroki Hori, Keizo Horibe

研究成果: Contribution to journalArticle査読

8 被引用数 (Scopus)

抄録

Purpose Osteonecrosis (ON) is a serious complication of the treatment of childhood acute lymphoblastic leukemia (ALL); however, data relating to ON in Asian pediatric patients with ALL are scarce. Therefore, we performed a retrospective analysis of cohorts of Japanese patients with ALL to clarify the incidence, clinical characteristics, and risk factors of ON. Patients and Methods The incidence and characteristics of ON were determined in patients with ALL (n = 1,662) enrolled in two studies from the Japan Association of Childhood Leukemia Study (JACLS) group (n = 635 and n = 1,027 patients treated with the ALL-97 and ALL-02 protocols, respectively). Results In total, 24 of 1,662 patients suffered from ON, of which 12 of 635 and 12 of 1,027 patients were treated with the ALL-97 and the ALL-02 protocol, respectively. Of the 24 patients, 23 were older than 10 years. In multivariate analysis, age ($ 10 years) was the sole significant risk factor for ON (P, .001). Separate evaluation of patients $ 10 years of age indicated a 5-year cumulative incidence of ON of 7.2% (95% CI, 4.0% to 12.6%) and 5.9% (95% CI, 3.3% to 10.4%) in the ALL-97 and the ALL-02 protocol, respectively, which was lower than reported previously, despite an administration of dexamethasone (DEX) similar to that in comparable studies; however, concomitant administration of DEX and L-asparaginase was reduced in the JACLS protocols. Conclusion We identified a low frequency of ON in the JACLS ALL-97 and ALL-02 studies. Although the sole risk factor for ON was age ($ 10 years), even among high-risk patients, ON incidence was significantly lower than that reported in previous studies. These results suggest that, not only the total amount of DEX, but also how DEX and L-asparaginase are administered, which affects the clearance of DEX, may be associated with ON incidence in patients with ALL.

本文言語英語
ページ(範囲)900-907
ページ数8
ジャーナルJournal of Clinical Oncology
36
9
DOI
出版ステータス出版済み - 2018
外部発表はい

All Science Journal Classification (ASJC) codes

  • 腫瘍学
  • 癌研究

フィンガープリント

「Low incidence of osteonecrosis in childhood acute lymphoblastic leukemia treated with ALL-97 and ALL-02 study of Japan association of childhood leukemia study group」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル