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A revised definition for cure of childhood acute lymphoblastic leukemia

Pui, C H ; Pei, D ; Campana, D ; Cheng, C ; Sandlund, J T ; Bowman, W P ; Hudson, M M ; Ribeiro, R C ; Raimondi, S C ; Jeha, S ; Howard, S C ; Bhojwani, D ; Inaba, H ; Rubnitz, J E ; Metzger, M L ; Gruber, T A ; Coustan-Smith, E ; Downing, J R ; Leung, W H ; Relling, M V ; Evans, W E

Leukemia, 2014-12, Vol.28 (12), p.2336-2343 [Periódico revisado por pares]

England: Nature Publishing Group

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Título:
A revised definition for cure of childhood acute lymphoblastic leukemia
Autor: Pui, C H ; Pei, D ; Campana, D ; Cheng, C ; Sandlund, J T ; Bowman, W P ; Hudson, M M ; Ribeiro, R C ; Raimondi, S C ; Jeha, S ; Howard, S C ; Bhojwani, D ; Inaba, H ; Rubnitz, J E ; Metzger, M L ; Gruber, T A ; Coustan-Smith, E ; Downing, J R ; Leung, W H ; Relling, M V ; Evans, W E
Assuntos: Acute lymphoblastic leukemia ; Acute lymphocytic leukemia ; Adolescent ; Analysis ; Cancer therapies ; Care and treatment ; Child ; Child, Preschool ; Children ; Clinical trials ; Clinical Trials as Topic ; Combined Modality Therapy - adverse effects ; Female ; Forecasts and trends ; Humans ; Infant ; Infant, Newborn ; Irradiation ; Leukemia ; Leukemia in children ; Lymphatic leukemia ; Lymphoblastic leukemia in children ; Lymphocytic leukemia in children ; Male ; Mortality ; Neoplasms, Second Primary ; Oncology ; Patients ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Radiation ; Radiation therapy ; Recurrence ; Remission ; Remission (Medicine) ; Remission Induction ; Risk Factors ; Skull ; Survival ; Therapy ; Time Factors ; Treatment Outcome ; Tumors
É parte de: Leukemia, 2014-12, Vol.28 (12), p.2336-2343
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: With improved contemporary therapy, we reassess long-term outcome in patients completing treatment for childhood acute lymphoblastic leukemia (ALL) to determine when cure can be declared with a high degree of confidence. In six successive clinical trials between 1984 and 2007, 1291 (84.5%) patients completed all therapies in continuous complete remission. The post-therapy cumulative risk of relapse or development of a second neoplasm and the event-free survival rate and overall survival were analyzed according to the presenting features and the three treatment periods defined by relative outcome. Over the three treatment periods, there has been progressive increase in the rate of event-free survival (65.2% vs 74.8% vs 85.1% (P<0.001)) and overall survival (76.5% vs 81.1% vs 91.7% (P<0.001)) at 10 years. The most important predictor of outcome after completion of therapy was the type of treatment. In the most recent treatment period, which omitted the use of prophylactic cranial irradiation, the post-treatment cumulative risk of relapse was 6.4%, death in remission 1.5% and development of a second neoplasm 2.3% at 10 years, with all relapses except one occurring within 4 years of therapy. None of the 106 patients with the t(9;22)/BCR-ABL1, t(1;19)/TCF3-PBX1 or t(4;11)/MLL-AFF1 had relapsed after 2 years from completion of therapy. These findings demonstrate that with contemporary effective therapy that excludes cranial irradiation, approximately 6% of children with ALL may relapse after completion of treatment, and those who remain in remission at 4 years post treatment may be considered cured (that is, less than 1% chance of relapse).
Editor: England: Nature Publishing Group
Idioma: Inglês

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A revised definition for cure of childhood acute lymphoblastic leukemia

Pui, C H ; Pei, D ; Campana, D ; Cheng, C ; Sandlund, J T ; Bowman, W P ; Hudson, M M ; Ribeiro, R C ; Raimondi, S C ; Jeha, S ; Howard, S C ; Bhojwani, D ; Inaba, H ; Rubnitz, J E ; Metzger, M L ; Gruber, T A ; Coustan-Smith, E ; Downing, J R ; Leung, W H ; Relling, M V ; Evans, W E

England: Nature Publishing Group

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