Long-term efficacy of CAMSBDH-ALL chemotherapy protocol for the treatment of childhood acute lymphoblastic leukemia
CHEN Xiao-Juan, ZOU Yao, CHEN Yu-Mei, YANG Wen-Yu, WANG Shu-Chun, GUO Ye, ZHANG Li, RUAN Min, LIU Xiao-Ming, LIU Fang, LIU Tian-Feng, ZHANG Jia-Yuan, Qi Ben-Quan, CHANG Li-Xian, ZHU Xiao-Fan
Institute of Hematology, Blood Disease Hospital, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College, Tianjin 300020, Chian
Abstract：Objective To study the long-term efficacy of CAMSBDH-ALL chemotherapy protocol for the treatment of childhood acute lymphoblastic leukemia (ALL). Methods Three hundred and eighteen children who were newly diagnosed with ALL between January 1999 and December 2007 were enrolled in this study. Among the 318 children, 83 children who hospitalized before December 2002 were treated with CAMSBDH-ALL99 protocol, including 48 patients of standard risk and 35 patients of high risk. The patients (n=235; 131 in standard risk and 104 in high risk) who hospitalized after December 2002 were treated with CAMSBDH-ALL03 protocol. Patients in the CAMSBDHALL99 protocol group were treated with conventional chemotherapy. CAMSBDH-ALL03 protocol was modified based on the CAMSBDH-ALL99 protocol. Results The long-term overall survival (OS) and event-free-survival (EFS) in the CAMSBDH-ALL03 group was significantly higher than in the CAMSBDH-ALL99 (P<0.01). The long-term OS and EFS of standard risk and high risk patients in the CAMSBDH-ALL03 protocol group were significantly higher than in the CAMSBDH-ALL99 protocol group (P<0.01). The CAMSBDH-ALL03 protocol group showed a significantly lower recurrence rate (28.9%) than in the CAMSBDH-ALL99 protocol group (50.6%) (P<0.05). The mortality rate in the CAMSBDH-ALL03 protocol group was 28.5% vs 56.6% in the CAMSBDH-ALL99 protocol group (P<0.05). Conclusions The therapeutic effect of the CAMSBDH-ALL03 protocol is supior to the CAMSBDH-ALL99 protocol group for childhood ALL, with a higher long-term survival rate.
CHEN Xiao-Juan,ZOU Yao,CHEN Yu-Mei et al. Long-term efficacy of CAMSBDH-ALL chemotherapy protocol for the treatment of childhood acute lymphoblastic leukemia[J]. CJCP, 2014, 16(10): 1019-1024.
Pui CH, Mullighan CG, Evans WE, et al. Pediatric acutelymphoblastic leukemia: where are we going and how do we getthere? [J]. Blood, 2012, 120(6): 1165-1174.
McCredie M, Williams S, Coates M. Cancer mortality inmigrants from the British Isles and continental Europe to NewSouth Wales, Australia, 1975-1995[J]. Int J Cancer, 1999, 83(2):179-185.
[6]
Yeoh AE, Tan D, Li CK, et al. Management of adult andpaediatric acute lymphoblastic leukaemia in Asia: resourcestratifiedguidelines from the Asian Oncology Summit 2013[J].Lancet Oncol, 2013, 14(12): e508-e523.
[7]
Pui CH, Carroll WL, Meshinchi S, et al. Biology, riskstratification and therapy of pediatric leukemias: an update[J]. JClin Oncol, 2011, 29(5): 551-565.
[8]
Crist W, Boyett J, Pullen J, et al. Clinical and biologic featurespredict poor prognosis in acute lymphoid leukemias in childrenand adolescents: a Pediatric Oncology Group review[J]. MedPediatr Oncol, 1986, 14(3): 135-139.
[9]
Taskov H, Dimitrova E, Serbinova M, et al. Immunologicalsubtypes of childhood acute lymphoblastic leukemia inBulgaria[J]. Leuk Res, 1995, 19(11): 877-881.
Silverman LB, Stevenson KE, O'Brien JE, et al. Long-termresults of Dana-Farber Cancer Institute ALL Consortiumprotocols for children with newly diagnosed acute lymphoblasticleukemia (1985-2000) [J]. Leukemia, 2010, 24(2): 320-334.
Locatelli F, Schrappe M, Bernardo ME, et al. How I treatrelapsed childhood acute lymphoblastic leukemia[J]. Blood,2012, 120(14): 2807-2816.
[15]
Pui CH, Boyett JM, Ruvera GK, et al. Long-term results ofTotal Therapy studies 11, 12 and 13A for childhood acutelymphoblastic leukemia at St Jude Children's ResearchHospital[J]. Leukemia, 2000, 14(12): 2286-2294.
[16]
Schrappe M, Reiter A, Zimmermann M, et al. Long-term resultsof four consecutive trials in childhood ALL performed by theALL-BFM study group from 1981 to 1995[J]. Leukemia, 2000,14(12): 2205-2222.
[17]
Nguyen K, Devidas M, Cheng SC, et al. Factors infl uencingsurvival after relapse from acute lymphoblastic leukemia: aChildren's Oncology Group study[J]. Leukemia, 2008, 22(12):2142-2150.
[18]
Mitchell CD, Richards SM, Kinsey SE, et al. Benefit ofdexamethasone compared with prednisolone for childhood acutelymphoblastic leukaemia: results of the UK Medical ResearchCouncil ALL97 randomized trial[J]. Br J Haematol, 2005,129(6): 734-745.
[19]
Pinkel D. Treatment of acute lymphoblastic leukemia in asecond remission[J]. N Engl J Med, 1995, 332(12): 823-824.
[20]
Vora A, Goulden N, Wade R, et al. Treatment reduction forchildren and young adults with low-risk acute lymphoblasticleukaemia defined by minimal residual disease: a randomisedcontrolled trial[J]. Lancet Oncol, 2013, 14(3): 199-209.
Pui CH, Campana D, Pei D, et al. Treating childhood acutelymphoblastic leukemia without cranial irradiation[J]. N Engl JMed, 2009, 360(26): 2730-2741.
[23]
Hunger SP, Lu X, Devidas M, et al. Improved survival forchildren and adolescents with acute lymphoblastic leukemiabetween 1990 and 2005: a report from the Children's OncologyGroup[J]. J Clin Oncol, 2012, 30(14): 1663-1669.
[24]
Vrooman LM, Stevenson KE, Supko JG, et al. Postinductiondexamethasone and individualized dosing of EscherichiaColi L-asparaginase each improve outcome of childrenand adolescents with newly diagnosed acute lymphoblasticleukemia: results from a randomized study--Dana-Farber CancerInstitute ALL Consortium Protocol 00-01[J]. J Clin Oncol, 2013,31(9): 1202-1210.
