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Treatment of relapsed acute lymphoblastic leukemia: approaches used by pediatric oncologists and bone marrow transplant physicians. Pediatr Blood Cancer 2012 Jun;58(6):840-5

Date

07/29/2011

Pubmed ID

21796765

DOI

10.1002/pbc.23269

Scopus ID

2-s2.0-84858685922   4 Citations

Abstract

BACKGROUND: Management of relapsed B-precursor acute lymphoblastic leukemia (ALL) is challenging and varied. We hypothesized that treatment approaches differ between pediatric oncologists and bone marrow transplant (BMT) physicians.

PROCEDURE: A survey addressing management of relapsed ALL was sent to pediatric oncologists (n = 883) and BMT (n = 86) physicians across North America.

RESULTS: A number of similarities in treatment approaches were identified including: choice of chemotherapy for re-induction/consolidation, preference for unrelated donors (URDs) in very early marrow relapse and the choice to not use URD donors in late marrow relapse. However, differences between the two disciplines were noted. For patients who relapsed 18-36 months from diagnosis, the majority of oncologists (53.7%) would retreat with chemotherapy while a majority BMT physicians (70.3%) recommended URD transplant (P < 0.001). Oncologists were also less likely to use minimal residual disease (MRD) in relapse assessment compared to BMT physicians (52% vs. 67.2%; P = 0.028) and more oncologists believed MRD testing was experimental and/or not proven in relapsed ALL (27.1% vs. 12.3%; P = 0.011).

CONCLUSIONS: This study highlights management differences in children with ALL between pediatric oncologists and BMT physicians, identifying opportunities for collaborative clinical trials.

Author List

Burke MJ, Lindgen B, Verneris MR

Author

Michael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Antineoplastic Agents
Bone Marrow Transplantation
Humans
Medical Oncology
Pediatrics
Physicians
Practice Patterns, Physicians'
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Recurrence
Salvage Therapy
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a