Long-term results of three randomized trials (58831, 58832, 58881) in childhood acute lymphoblastic leukemia: a CLCG-EORTC report. Children Leukemia Cooperative Group.

摘要: We present here the long-term results of three randomized clinical trials conducted on children with newly diagnosed acute lymphoblastic leukemia (ALL) between 1983 and 1998 by Children Leukemia Cooperative Group (CLCG) from EORTC. In study 58831/32, overall event-free survival (EFS) rates (+/- s.e.) at 6 10 years were 66% +/- 1.8% 65% 1.8%, respectively, risk isolated central nervous system (CNS) relapse was 6% 1% 7% 1%, respectively. patients a standard omission cyclophosphamide had no adverse effect disease-free (trial 58831). medium- high-risk radiotherapy did not increase CNS or systemic 58832). 58881 (1989-1998) EFS rate 8 68.4% 1.2% 4.2%+/-0.5%. this trial which adressed questions, following obtained: combination cytarabine high doses methotrexate during interval therapy improve prognosis. The addition 6-mercaptopurine iv maintenance increased late relapse. E. coli asparaginase more toxic has higher efficacy than Erwinia asparaginase. Leukocyte counts >100 x 10(9)/l, specific genetic abnormalities, poor initial response to steroids level minimal residual disease early time points consistently associated an prognosis in trial.