Antimetabolite therapy for lesser-risk B-lineage acute lymphoblastic leukemia of childhood: a report from Children's Oncology Group Study P9201. Blood 2007 Aug 15;110(4):1105-11
Date
04/20/2007Pubmed ID
17442849Pubmed Central ID
PMC1939894DOI
10.1182/blood-2006-12-061689Scopus ID
2-s2.0-34548014052 (requires institutional sign-in at Scopus site) 49 CitationsAbstract
Pediatric Oncology Group (POG) protocol 9201 enrolled children with lesser-risk B-lineage acute lymphoblastic leukemia (ALL) defined by age (1-9), white blood cell count (WBC) less than 50 x 10(9)/L (50,000/microL), DNA findings of trisomies 4 and 10 (or DNA index > 1.16), and lack of overt central nervous system (CNS) leukemia. After vincristine, prednisone, and asparaginase induction, 650 of 653 eligible patients attained remission (3 induction deaths) and received 6 courses of intravenous methotrexate (1 g/m(2)) with daily mercaptopurine. Weekly intramuscular methotrexate was added during maintenance; pulses of vincristine and prednisone were administered with periodic intrathecal chemotherapy. Treatment duration was 2.5 years. No alkylators, epipodophylotoxins, anthracyclines, or radiation were given. The 6-year event-free survival (EFS) was 86.6% with overall survival (OS) of 97.2%. Patients with less than 5% marrow blasts on induction day 15 had superior EFS. A difference not reaching conventional statistical significance (P = .068) was noted for superior outcomes in patients with trisomies of chromosomes 4 and 10 versus those lacking double trisomies. Sex, ethnicity, CNS status, and WBC were not predictive. This indicates the great majority of children with lesser-risk B-lineage ALL are curable without agents with substantial late effects.
Author List
Chauvenet AR, Martin PL, Devidas M, Linda SB, Bell BA, Kurtzberg J, Pullen J, Pettenati MJ, Carroll AJ, Shuster JJ, Camitta BMESH terms used to index this publication - Major topics in bold
Antineoplastic Combined Chemotherapy ProtocolsAsparaginase
B-Lymphocytes
Cell Lineage
Central Nervous System Neoplasms
Child
Child, Preschool
Disease-Free Survival
Female
Humans
Infant
Infusions, Intravenous
Injections, Intramuscular
Injections, Spinal
Male
Mercaptopurine
Methotrexate
Pilot Projects
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prednisone
Remission Induction
Treatment Outcome
Vincristine