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[Treatment of infantile acute lymphoblastic leukemia with protocol ALL-BFM 83]
F J Aracil Santos1, M Bernacer Borja, J López Pérez
1Fundación Jiménez Díaz, Servicio de Pediatría, Madrid.
Insights
This study analyzed 63 children with non-B acute lymphoblastic leukemia treated with the ALL-BFM 83 protocol. High remission rates were observed, but early indicators like blast cell counts predict treatment outcomes.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Trials
Context:
- Acute lymphoblastic leukemia (ALL) is a significant childhood cancer.
- The ALL-BFM 83 protocol is a treatment regimen for ALL.
- Non-B ALL represents a specific subtype requiring tailored treatment analysis.
Purpose:
- To evaluate the efficacy and toxicity of the ALL-BFM 83 protocol in children with non-B acute lymphoblastic leukemia.
- To identify prognostic factors influencing treatment outcomes in this patient cohort.
Summary:
- The study analyzed 63 children with non-B ALL treated with the ALL-BFM 83 protocol, achieving a 95% complete remission rate.
- Overall event-free survival (EFS) was 66% at 48 months, with hematological toxicity as the primary adverse effect.
- Independent risk factors for poor outcomes included persistent high blast cell counts (>1,000/microl) after 7 days of prednisone and enlarged spleen size (>5 cm).
Impact:
- Identified critical early indicators for predicting treatment success in non-B ALL.
- Demonstrated the effectiveness of the ALL-BFM 83 protocol while highlighting areas for risk stratification.
- Results provide valuable data for refining treatment strategies and improving EFS in pediatric ALL patients.
Abstract:
The outcome of 63 children with non-B acute lymphoblastic leukemia treated with ALL-BFM 83 protocol is analyzed. 95% achieved complete remission with the initial treatment. For the entire group the event free survival (EFS) was 66% (+/- 9%) at 48 months. These results were close to those obtained by the BFM group. Haematological toxicity was the main adverse effect, but there where no therapy related deaths. Persistence of more than 1,000 blast cells per microl in peripheral blood after 7th days of prednisone monotherapy, and spleen size greater than or equal to 5 cm under the costal margin, were identified as independent risk factors of high significance. The EFS in patients with poor clinical response to steroids (greater than or equal to 1,000 blast/microl at day 8) was 22% (+/- 18%), instead of 69% (+/- 12%) in those with adequate response.