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Updated: Aug 7, 2026
Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia
Published on: September 18, 2013
[Prognosis of acute lymphoblastic leukemia in children. Results of the French protocol FRALLE 93]
G Schaison1, M F Auclerc, A Baruchel
1Service de Pédiatrie à Orientation Hématologique-Hôpital Saint-Louis, 1 avenue Claude Vellefaux-75475 Paris.
Insights
This study on childhood acute lymphoblastic leukemia (ALL) found that prognostic factors like age and genetics help predict survival. Identifying these factors aids in tailoring treatments for better outcomes.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Research
Context:
- Protocol FRALLE 93 involved 1,120 children diagnosed with acute lymphoblastic leukemia (ALL) between June 1993 and September 1998.
- Disease-Free Survival (DFS) was 78% ± 3%, and Overall Survival (OS) was 83% ± 3% for the entire cohort.
Purpose:
- To correlate clinical and laboratory features at diagnosis with prognosis in childhood ALL.
- To identify prognostic factors for stratifying patients into risk-based treatment subgroups.
- To inform the design of current and future therapeutic trials for childhood ALL.
Summary:
- Prognostic indicators for childhood ALL include age, white blood cell count, tumor burden, cytogenetics (chromosome number and translocations), immunophenotype, and early treatment response.
- Molecular biology advancements have enabled gene identification in leukemia and sensitive detection of minimal residual disease (MRD).
- Improved MRD detection facilitates risk-adapted therapy, allowing for intensified treatment in poor responders and potentially reduced therapy for good responders.
Impact:
- Establishes key prognostic factors for childhood ALL, crucial for treatment stratification.
- Highlights the role of molecular techniques in refining diagnosis and prognosis.
- Suggests a paradigm shift towards personalized therapy based on MRD levels and individual risk assessment.
Abstract:
1,120 children were included in protocol FRALLE 93 from june 1993 to september 1998. Disease Free Survival for the all protocol is 78% +/- 3 and overall survival 83% +/- 3. Various clinical and laboratory features at the time of diagnosis have been correlated with prognosis. They provide a potential mean to stratify patients into treatment subgroups according their relative risk of treatment failure. The identification of these prognostic factors has been an essential element in the design of current therapeutic trials. Prognostic characteristics of childhood ALL include: age, white blood cell count, tumor burden, cytogénétics (chromosome count and chromosomal translocation), immunophenotype and early response to treatment. Molecular biology has been the revolution of the last two decades permitting the cloning of the genes involved in the leukemic process. Finally the new molecular techniques allow a sensitive diagnostic approach to minimal residual disease (MRD). The better detection of MRD must allow a more rational basis for therapeutic intensification for a subset of poor responder patients. A decrease in therapy of very good responders can also be envisaged.
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