Abstract Objective To study the long-term clinical effect of CCLG-ALL2008 regimen in the treatment of children and adolescents, aged > 10 years, with newly diagnosed acute lymphoblastic leukemia (ALL). Methods A retrospective analysis was performed for the clinical data of 150 ALL children and adolescents aged > 10 years who were treated with CCLG-ALL2008 regimen from April 2008 to April 2015. The Kaplan-Meier method was used to analyze overall survival (OS) rate and event-free survival (EFS) rate. Results Among the 150 children and adolescents, there were 87 (58.0%) boys and 63 (42.0%) girls, with a median age of 11 years (range 10-15 years). Of the 150 children and adolescents, 84 (56.0%) had intermediate risk and 66 (44.0%) had high risk; 122 (81.3%) had B-lineage acute lymphoblastic leukemia (B-ALL) and 28 (18.7%) had T-lineage acute lymphoblastic leukemia (T-ALL). The fusion gene test yielded positive results in 51 children and adolescents (34.0%), among whom 16 (31%) had positive BCR-ABL, 11 (22%) had positive TEL-AML1, 8 (16%) had positive E2A-PBX1, and 16 (31%) were positive for other fusion genes. The complete remission rate was 96.0% (144/150) after one course of treatment with CCLG-ALL2008 regimen. The median follow-up time was 52 months (range 3-122 months). The 5-year OS rate was 79.0%±3.5%, and the 5-year EFS rate was 67.3%±4.1%. There were no significant differences in 5-year OS and EFS rates between the children with intermediate or high risk, as well as between the children with B-ALL or T-ALL (P > 0.05). The children and adolescents who achieved complete remission of bone marrow at the end of induction therapy had significantly higher 5-year OS and EFS rates than those who did not achieve complete remission (P < 0.05). Conclusions In ALL children and adolescents aged > 10 years, CCLG-ALL2008 regimen can help to achieve high complete remission rate, 5-year OS rate and 5-year EFS rate. The children and adolescents failing to achieve complete remission at the end of induction therapy tend to have a poor prognosis.
LAN Yang,CHEN Xiao-Juan,ZOU Yao et al. Clinical effect of CCLG-ALL2008 regimen in treatment of children and adolescents aged > 10 years with acute lymphoblastic leukemia[J]. CJCP, 2019, 21(5): 405-410.
LAN Yang,CHEN Xiao-Juan,ZOU Yao et al. Clinical effect of CCLG-ALL2008 regimen in treatment of children and adolescents aged > 10 years with acute lymphoblastic leukemia[J]. CJCP, 2019, 21(5): 405-410.
Lustosa de Sousa DW, de Almeida Ferreira FV, Cavalcante Félix FH, et al. Acute lymphoblastic leukemia in children and adolescents:prognostic factors and analysis of survival[J]. Rev Bras Hematol Hemoter, 2015, 37(4):223-229.
[5]
Chiaretti S, Vitale A, Cazzaniga G, et al. Clinico-biological features of 5202 patients with acute lymphoblastic leukemia enrolled in the Italian AIEOP and GIMEMA protocols and stratified in age cohorts[J]. Haematologica, 2013, 98(11):1702-1710.
Gao C, Zhao XX, Li WJ, et al. Clinical features, early treatment responses, and outcomes of pediatric acute lymphoblastic leukemia in China with or without specific fusion transcripts:a single institutional study of 1,004 patients[J]. Am J Hematol, 2012, 87(11):1022-1027.
Conter V, Bartram CR, Valsecchi MG, et al. Molecular response to treatment redefines all prognostic factors in children and adolescents with B-cell precursor acute lymphoblastic leukemia:results in 3184 patients of the AIEOP-BFM ALL 2000 study[J]. Blood, 2010, 115(16):3206-3214.
[12]
Pui CH, Pei D, Campana D, et al. Improved prognosis for older adolescents with acute lymphoblastic leukemia[J]. J Clin Oncol, 2011, 29(4):386-391.
[13]
Barry E, DeAngelo DJ, Neuberg D, et al. Favorable outcome for adolescents with acute lymphoblastic leukemia treated on Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium Protocols[J]. J Clin Oncol, 2007, 25(7):813-819.
[14]
Hochberg J, Khaled S, Forman SJ, et al. Criteria for and outcomes of allogeneic haematopoietic stem cell transplant in children, adolescents and young adults with acute lymphoblastic leukaemia in first complete remission[J]. Br J Haematol, 2013, 161(1):27-42.
[15]
Flohr T, Schrauder A, Cazzaniga G, et al. Minimal residual disease-directed risk stratification using real-time quantitative PCR analysis of immunoglobulin and T-cell receptor gene rearrangements in the international multicenter trial AIEOP-BFM ALL 2000 for childhood acute lymphoblastic leukemia[J]. Leukemia, 2008, 22(4):771-782.
[16]
Athale UH, Gibson PJ, Bradley NM, et al. Minimal residual disease and childhood leukemia:standard of care recommendations from the pediatric oncology group of ontario MRD working group[J]. Pediatr Blood Cancer, 2016, 63(6):973-982.
