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[Improved results in children with acute lymphoblastic leukemia treated with the ALL-BFM 90 protocol in the Czech
Insights
Treatment outcomes for childhood acute lymphoblastic leukemia (ALL) improved significantly in the Czech Republic using the ALL-BFM 90 protocol. Event-free survival reached 71.3% and overall survival 76.4% in this pediatric cancer study.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Trials
Background:
- Childhood acute lymphoblastic leukemia (ALL) is the most common pediatric cancer.
- Significant advancements in ALL treatment have improved prognosis over recent decades.
- The ALL-BFM 90 Study protocol aimed to further enhance treatment outcomes.
Purpose of the Study:
- To evaluate the treatment outcomes of children with ALL in the Czech Republic.
- To assess the efficacy of the ALL-BFM 90 Study protocol.
- To compare current results with previous treatment protocols.
Main Methods:
- A cohort of 352 children aged 0-18 years with ALL were treated between 1990-1996.
- Patients were stratified into standard-risk (SR), medium-risk (MR), and high-risk (HR) groups.
- Chemotherapy duration was two years, with a median follow-up of 7.3 years.
Main Results:
- Event-free survival (EFS) was 71.3% and overall survival (OS) was 76.4%.
- EFS rates varied by risk group: 80.3% (SR), 74% (MR), and 28.2% (HR).
- Relapse occurred in 17.8% of patients.
Conclusions:
- Treatment outcomes for childhood ALL significantly improved compared to the prior ALL-BFM 83 study (EFS 62%, p=0.0045).
- The results achieved with the ALL-BFM 90 protocol are comparable to international leading study groups.
- This study highlights the effectiveness of risk-stratified treatment protocols in pediatric ALL.
Background:
Prognosis of children with acute lymphoblastic leukaemia (ALL)--the most common cancer in childhood, has improved remarkably over the last 40 years. The authors report the treatment outcome in children with ALL cured according to ALL-BFM 90 Study protocol in the Czech Republic during the first half of nineties.
Methods And Results:
Children aged 0-18 years were included into the study in 10 centers between 1990 to 1996. Patients were classified into standard-risk (SR), medium-risk (MR) and high-risk (HR) group according to initial leukaemic burden, early treatment response, and genotype of leukaemia. Duration of the chemotherapy was two years. Treatment results were evaluated in 352 children. With a median follow-up of 7.3 years, event-free-survival (EFS) was 71.3% and overall survival 76.4%. EFS was 80.3%, 74% and 28.2% in SR, MR and HR group, respectively. Relapse was diagnosed in 17.8% of the patients.
Conclusions:
The treatment outcome of children with ALL improved significantly (p = 0.0045) compared to the previous study ALL-BFM 83 (EFS 62%). These results are comparable to those achieved by leading leukaemia study groups in the world.
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