Treatment for childhood acute lymphoblastic leukemia in Taiwan: Taiwan Pediatric Oncology Group ALL-2002 study emphasizing optimal reinduction therapy and central nervous system preventive therapy without cranial radiation

Meng Ju Li, Hsi Che Liu, Hsiu Ju Yen, Tang Her Jaing, Dong Tsamn Lin, Chao Ping Yang, Kai Hsin Lin, Iou Jih Hung, Shiann Tarng Jou, Meng Yao Lu, Chih Cheng Hsiao, Ching Tien Peng, Tai Tsung Chang, Shih Chung Wang, Ming Tsan Lin, Jiann Shiuh Chen, Te Kau Chang, Giun Yi Hung, Kang Hsi Wu, Yung Li YangHsiu Hao Chang, Shih Hsiang Chen, Ting Chi Yeh, Chao Neng Cheng, Pei Chin Lin, Shyh Shin Chiou, Jiunn Ming Sheen, Shin Nan Cheng, Shu Huey Chen, Yu Hsiang Chang, Wan Ling Ho, Yu Hua Chao, Rong Long Chen, Bow Wen Chen, Jinn Li Wang, Yuh Lin Hsieh, Yu Mei Liao, Shang Hsien Yang, Wan Hui Chang, Yu Mei Y. Chao, Der Cherng Liang

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: Reinduction therapy has improved the outcomes in children with acute lymphoblastic leukemia (ALL). We sought to determine the optimal course(s) of reinduction therapy for standard-risk (SR, or “low-risk” in other groups) patients. Also, we evaluated outcomes using triple intrathecal therapy without cranial radiation (CrRT) for central nervous system (CNS) preventive therapy. Procedure: From 2002 to 2012, all newly diagnosed children with ALL in Taiwan were enrolled in Taiwan Pediatric Oncology Group ALL-2002 protocol. SR patients were randomized to receive single or double reinduction courses. The patients enrolled before 2009 received CrRT, while those enrolled later did not. The Kaplan–Meier method was used to estimate survival rates and the difference between two groups was compared by the two-sided log-rank test. Results: In 1,366 eligible patients, the 5-year overall survival (OS) was 81.6 ± 1.1% (standard error) and 5-year event-free survival (EFS) was 74.3 ± 1.2%. In SR patients, the 5-year OS for one and two reinduction courses was 91.6 ± 2.1% and 93.7 ± 1.8%, respectively, and the 5-year EFS was 85.2 ± 2.7% and 89.8 ± 2.3%, respectively. There were no significant differences in survival between these two groups. Patients with MLL or BCR-ABL1 had the worst outcomes: 5-year EFS was 23.4 and 31.8% and 5-year OS was 28.6 and 44.7%, respectively. There was no significant difference in CNS relapse or survival between the era with or without CrRT. Conclusions: For SR patients, one-course reinduction was adequate. Triple intrathecal therapy alone successfully prevented CNS relapse.

Original languageEnglish
Pages (from-to)234-241
Number of pages8
JournalPediatric Blood and Cancer
Volume64
Issue number2
DOIs
Publication statusPublished - 2017 Feb 1

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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