TY - JOUR
T1 - Effective VCR/DEX pulse maintenance therapy in the KYCCSG ALL-02 protocol for pediatric acute lymphoblastic leukemia
AU - Okamoto, Yasuhiro
AU - Koga, Yuki
AU - Inagaki, Jiro
AU - Ozono, Shuichi
AU - Ueda, Koichiro
AU - Shimoura, Maiko
AU - Itonaga, Nobuyoshi
AU - Shinkoda, Yuichi
AU - Moritake, Hiroshi
AU - Nomura, Yuko
AU - Nakayama, Hideki
AU - Hotta, Noriko
AU - Hidaka, Yasufumi
AU - Shimonodan, Hidemi
AU - Suga, Naohiro
AU - Tanabe, Takayuki
AU - Nakashima, Kentaro
AU - Fukano, Reiji
AU - Kawano, Yoshifumi
N1 - Funding Information:
We would like to show out great appreciation to Dr. Jun Okamura and Dr. Akinobu Matsuzaki, whose comments and suggestions were innumerably valuable throughout the course of our study, and Dr. Yoshihisa Nagatoshi and Dr. Aiko Suminoe, whose contribution were valuable in the design of our study. This work was supported by the Children’s Cancer Association of Japan.
Publisher Copyright:
© 2015, The Japanese Society of Hematology.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - In a previous study of childhood acute lymphoblastic leukemia (ALL) by the Kyushu–Yamaguchi Children’s Cancer Study Group, ALL-96, we achieved a 72.1 % 5-year event-free survival (EFS) and an 84.8 % 5-year overall survival (OS). In a subsequent study, ALL-02, we adopted a vincristine dexamethasone (VCR/DEX) pulse regimen as maintenance therapy in the context of the ALL-96 study using the same risk classification and treatment schedule. A total of 156 pediatric cases of ALL were treated with ALL-02. All of the patients were classified as standard-risk or high-risk. Risk stratification was based on white cell counts, immunophenotype, the presence of central nervous system (CNS) disease at diagnosis, organomegaly, and early treatment response (day 14 bone marrow status). The 7-year EFS and OS rates were 77.7 % (95 % CI 70.6–84.8 %) and 89.5 % (95 % CI 84.6–94.4 %), respectively. CNS 3 status [hazard ratio (HR) = 5.0, p = 0.009] and high white blood cell count at diagnosis (HR = 2.6, p = 0.047) were risk factors for poor EFS in multivariate analysis. Our strategies to categorize patients into two risk groups, and to treat with a VCR/DEX pulse were feasible and reasonably effective treatments for pediatric ALL.
AB - In a previous study of childhood acute lymphoblastic leukemia (ALL) by the Kyushu–Yamaguchi Children’s Cancer Study Group, ALL-96, we achieved a 72.1 % 5-year event-free survival (EFS) and an 84.8 % 5-year overall survival (OS). In a subsequent study, ALL-02, we adopted a vincristine dexamethasone (VCR/DEX) pulse regimen as maintenance therapy in the context of the ALL-96 study using the same risk classification and treatment schedule. A total of 156 pediatric cases of ALL were treated with ALL-02. All of the patients were classified as standard-risk or high-risk. Risk stratification was based on white cell counts, immunophenotype, the presence of central nervous system (CNS) disease at diagnosis, organomegaly, and early treatment response (day 14 bone marrow status). The 7-year EFS and OS rates were 77.7 % (95 % CI 70.6–84.8 %) and 89.5 % (95 % CI 84.6–94.4 %), respectively. CNS 3 status [hazard ratio (HR) = 5.0, p = 0.009] and high white blood cell count at diagnosis (HR = 2.6, p = 0.047) were risk factors for poor EFS in multivariate analysis. Our strategies to categorize patients into two risk groups, and to treat with a VCR/DEX pulse were feasible and reasonably effective treatments for pediatric ALL.
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U2 - 10.1007/s12185-015-1910-1
DO - 10.1007/s12185-015-1910-1
M3 - Article
C2 - 26586463
AN - SCOPUS:84955685038
SN - 0925-5710
VL - 103
SP - 202
EP - 209
JO - International journal of hematology
JF - International journal of hematology
IS - 2
ER -
