Third consecutive national study ALL-BFM 95 improved the outcome of acute lymphoblastic leukemia in children in the Czech Republic
Authors:
J. Starý 1; P. Gajdoš 1; H. Hrstková 2; L. Kopečná 2; J. Štěrba 3; D. Dembická 3; D. Mendelová 3; D. Pospíšilová 4; M. Hajdúch 4
; B. Blažek 5; H. Ptoszková 5; J. Hak 6; K. Toušovská 6; D. Procházková 7; Z. Černá 8; Y. Jabali 9; P. Timr 9; P. Smíšek 1; V. Vávra 1; K. Zdráhalová, (ČHS) 1; P. Sedláček 1; L. Šrámková 1; V. Komrska 1; E. Mejstříková 1; A. Vrzalová 1; K. Kramarzová 1; K. Michalová 10; Z. Zemanová 10; M. Jarošová 11; J. Housková 12; J. Zuna 1; O. Hrušák 1; J. Trka 1; V. Mihál 4
Authors place of work:
Klinika dětské hematologie a onkologie UK 2. LF a FN Motol, Praha, 2I. dětská interní klinika LF MU a FN Brno, 3Klinika dětské onkologie FN Brno, 4Dětská klinika LF UP a FN Olomouc, 5Klinika dětského lékařství FN Ostrava, 6Dětská klinika FN Hradec Králové
1
Published in the journal:
Transfuze Hematol. dnes,14, 2008, No. 3, p. 102-109.
Category:
Souhrnné práce, původní práce, kazuistiky
Summary
Treatment of childhood acute lymphoblastic leukemia (ALL) according to the protocol ALL-BFM 95 was performed at 8 departments of pediatrics between 1996–2002 in the Czech Republic. Patients were stratified into 3 risk groups (standard risk-SR, medium risk-MR and high risk-HR) according to the early treatment response, age, initial WBC and the finding of translocations t(9;22) or t(4;11). Total duration of treatment was 2 years except for boys of SR for whom it was three years. 386 children were enrolled into the study and the treatment results were evaluable in 380 patients with a median follow-up of 8.2 years. Complete remission (CR) was achieved in 95.5% pts, 3.9% children died in CR. Stratification into the risk groups was as follows: SR 32.4%, MR 53.7% and HR 13.9%. 69 children (19%) suffered from relapse, isolated CNS relapse has been diagnosed only in 1.1%. Two children (0.6%) developed secondary cancer. Event-free survival (EFS) is 73.1% and overall survival (OS) 80.8%. The results improved in comparison with previous study ALL-BFM 90 (EFS 71.3%; OS 76.4%) despite treatment reduction for 2/3 of patients. EFS/OS were in SR 84.5/93.2%, MR 74/82.1% and HR 43.1/47.1%. The prognosis of T-ALL (EFS 64.8%) was significantly worse in comparison with BCP-ALL (EFS 75.8%). Only 7 children underwent stem cell transplantation in the first CR. Survival of children with ALL in the Czech Republic exceeded 80%. Significant improvement was particularly achieved in HR group (EFS in previous study only 28.2%).
Key words:
acute lymphoblastic leukemia, children, chemotherapy, protocol ALL-BFM 95, relapse
Zdroje
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Štítky
Hematologie a transfuzní lékařství Interní lékařství OnkologieČlánek vyšel v časopise
Transfuze a hematologie dnes
2008 Číslo 3
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