Τίτλος:
Could intensified treatment in childhood acute lymphoblastic leukemia
improve outcome independently of risk factors?
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose: Many risk-directed therapeutic protocols have been proposed in
acute lymphoblastic leukemia (ALL). However, the relapse rates remain
high. The effectiveness of each protocol depends on how quickly the
clearance of blast cells is achieved. In an attempt to improve survival,
by minimizing treatment toxicity and relapse rate, different therapeutic
protocols were used every 3 yr in our Unit. Patients and Methods: During
1991-2000, 132 children with ALL were diagnosed in our Unit. Modified
and intensified NY II and BFM protocols, in three consecutive periods
[(Hematology/Oncology Pediatric Department of the University of
Athens) HOPDA-91, HOPDA-94, HOPDA-97] were used. Results: At a median
follow-up time of 96 months, the 8-year overall survival (OS) was 88%
+/- 3%, whereas the event-free survival (EFS) was 85% +/- 3%. There
was a significant increase of the 5-year EFS of the high-risk (HR) group
through time (65% in HOPDA-91 vs. 80% in HOPDA-97), whereas EFS of the
low risk (LR) group in HOPDA-97 was 96%. Five cases relapsed (3.8%),
four of which underwent successful bone marrow transplantation. Fifteen
children died (13 diagnosed by 1996, two in the last 4 yr). Conclusion:
Modification of the protocols significantly improved survival in both HR
and LR groups. The intensified regimen in the LR group did not increase
the adverse toxic events, but on the contrary was extremely effective.
Συγγραφείς:
Tzortzatou-Stathopoulou, F
Moschovi, MA
Papadopoulou, AL and
Barbounaki, IG
Lambrou, GI
Balafouta, M
Syriopoulou, V
Περιοδικό:
European Journal of Haematology
Λέξεις-κλειδιά:
childhood; acute lymphoblastic leukemia; risk factors; intensified
protocol; outcome
DOI:
10.1111/j.1600-0609.2005.00527.x
