Outcome of childhood high-risk acute lymphoblastic leukemia treated with the ALLBFM 95 protocol

RUAN Yong-Sheng; WU Xue-Dong; FENG Xiao-Qin; HE Yue-Lin; ZHANG Yu-Ming; PEI Fu-Yu; LI Chun-Fu

doi:10.7499/j.issn.1008-8830.2015.04.007

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Chinese Journal of Contemporary Pediatrics ›› 2015, Vol. 17 ›› Issue (4) : 327-331. DOI: 10.7499/j.issn.1008-8830.2015.04.007

CLINICAL RESEARCH

Outcome of childhood high-risk acute lymphoblastic leukemia treated with the ALLBFM 95 protocol

RUAN Yong-Sheng, WU Xue-Dong, FENG Xiao-Qin, HE Yue-Lin, ZHANG Yu-Ming, PEI Fu-Yu, LI Chun-Fu

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Abstract

Objective To evaluate the effectiveness and the practicability of the Acute Lymphoblastic Leukemia Berlin-Frankfurt-Münster 95 (ALL-BFM 95) protocol in treating childhood high-risk acute lymphoblastic leukemia (HR-ALL). Methods A retrospective analysis of 47 children with newly diagnosed HR-ALL between July 2003 and August 2013 was performed. These children were treated by the ALL-BFM 95 protocol. Survival was evaluated by Kaplan Meier analysis and Log-Rank test. Results Relapse-related death occurred in 12 of 47 patients (26%), and 5 of 47 patients (11%) were treatment-related mortality. Five-year probability of event-free-survival (pEFS) was 62%. Children with hematopoietic stem cell transplantation (HSCT) after chemotherapy achieved significantly better pEFS than those with chemotherapy alone (77% vs 52%; P=0.035). The patients who were only poor responders to prednisone had a better outcome (5-year pEFS 80%) than the Days 15 and 33 bone marrow M3 subgroups (5- year pEFS 60% and 0 respectively). Conclusions ALL-BFM 95 protocol can improve the outcome of children with high-risk ALL. The major cause of death is attributed to relapse. Chemotherapy plus HSCT can produce a better outcome than chemotherapy alone. The Days 15 and 33 bone marrow M3 subgroups have a poor prognosis.

Key words

Acute lymphoblastic leukemia / High risk / Child

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RUAN Yong-Sheng, WU Xue-Dong, FENG Xiao-Qin, HE Yue-Lin, ZHANG Yu-Ming, PEI Fu-Yu, LI Chun-Fu. Outcome of childhood high-risk acute lymphoblastic leukemia treated with the ALLBFM 95 protocol[J]. Chinese Journal of Contemporary Pediatrics. 2015, 17(4): 327-331 https://doi.org/10.7499/j.issn.1008-8830.2015.04.007

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