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

doi:10.7499/j.issn.1008-8830.2014.10.012

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Chinese Journal of Contemporary Pediatrics ›› 2014, Vol. 16 ›› Issue (10) : 1019-1024. DOI: 10.7499/j.issn.1008-8830.2014.10.012

CLINICAL RESEARCH

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

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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.

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Acute lymphoblastic leukemia / Chemotherapy / Child

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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. Long-term efficacy of CAMSBDH-ALL chemotherapy protocol for the treatment of childhood acute lymphoblastic leukemia[J]. Chinese Journal of Contemporary Pediatrics. 2014, 16(10): 1019-1024 https://doi.org/10.7499/j.issn.1008-8830.2014.10.012

References

[1] 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.
[2] 张之南, 沈悌. 血液病诊断及疗效标准[M]. 第3 版. 北京:科学出版社, 2007: 19-23.
[3] 陈晓娟, 张丽, 刘天峰, 等. 225 例儿童急性淋巴细胞白血病临床疗效的回顾性分析[J]. 中华血液学杂志, 2008, 29(12):824-827.
[4] 陈晓娟, 张丽, 刘天峰, 等. 中剂量阿糖胞苷治疗儿童急性淋巴细胞白血病[J]. 实用儿科临床杂志, 2009, 24(3): 225-226, 231.
[5] 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.
[10] 张艳兰, 赵文理, 聂述山, 等. 儿童T 系急性淋巴细胞白血病的临床特点及预后分析[J]. 中国实验血液学杂志, 2011,6(19): 1496-1500.
[11] 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.
[12] 顾龙君, 李娟, 薛惠良, 等. ALL-XH-99 方案治疗儿童急性淋巴细胞白血病158 例疗效分析[J]. 中华血液学杂志, 2004,25(1): 1-4.
[13] 周敏, 顾龙君, 汤静燕, 等. ALL-2005 方案治疗儿童T 系急性淋巴细胞白血病35 例疗效[J]. 中国小儿与血液肿瘤杂志,2012, 17(5): 224-227.
[14] 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.
[21] 陈波, 宪莹, 苏庸春, 等. CCLG-ALL 08 方案治疗儿童急性淋巴细胞白血病毒副作用的临床研究[J]. 中国当代儿科杂志, 2013, 15(9): 737-742.
[22] 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.