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Long-term follow-up of acute lymphoblastic leukemia in young children treated by the SCMC-ALL-2009 protocol
Kangkang Liu1, Jinhua Chu1, Yu Dai1,2
1Department of Pediatrics, The Second Hospital of Anhui Medical University, Hefei, China.
Insights
The SCMC-ALL-2009 protocol shows improved long-term survival for young children with acute lymphoblastic leukemia (ALL). Key prognostic factors include MRD response and prednisolone sensitivity, guiding better treatment strategies.
Area of Science:
- Pediatric Hematology
- Oncology
- Clinical Trial Research
Background:
- Acute lymphoblastic leukemia (ALL) is a significant challenge in pediatric oncology.
- Early therapeutic effects and prognostic factors are crucial for optimizing treatment in young children.
Purpose of the Study:
- To evaluate the long-term therapeutic efficacy of the SCMC-ALL-2009 protocol for acute lymphoblastic leukemia in young children.
- To identify prognostic factors influencing treatment outcomes in this pediatric population.
Main Methods:
- A cohort of 100 children under 2 years old with ALL were enrolled in the SCMC-ALL-2009 study.
- Long-term event-free survival (EFS) was analyzed, comparing risk groups and treatment protocols.
- Prognostic implications of minimal residual disease (MRD) and prednisolone response were assessed.
Main Results:
- The 5-year and 10-year EFS rates were 74.7% and 73.3%, respectively.
- 10-year EFS varied significantly by risk group: 81.9% (low), 71.3% (intermediate), and 22.2% (high).
- The SCMC-ALL-2009 protocol demonstrated superior outcomes compared to the SCMC-ALL-2005 protocol, particularly in the intermediate-risk group with intensified chemotherapy.
Conclusions:
- The SCMC-ALL-2009 protocol offers improved long-term therapeutic effects for pediatric ALL.
- MRD on day 55, prednisolone response, and age at diagnosis are critical prognostic indicators.
- Adjusting chemotherapy intensity, especially for intermediate-risk patients, enhances survival rates.
Abstract:
This study evaluated the long-term therapeutic effect and prognostic factors of acute lymphoblastic leukemia (ALL) in 100 young Chinese children (<2 years old) who were enrolled in the Shanghai Children's Medical Center (SCMC)-ALL-2009 study in five pediatric hematological disease centers based on collaboration. The 5-year and 10-year event-free survivals (EFS) were 74.7 ± 3.2% and 73.3 ± 3.4%. The 10-year EFS rates for low risk, intermediate-risk, and high-risk patients were 81.9 ± 5.0%, 71.3 ± 4.3%, and 22.2 ± 13.9%, respectively. Relapse occurred in 19 patients. MRD results on day 55, good or poor response to prednisolone, and age at diagnosis were shown to have important prognostic and therapeutic implications. Compared with the SCMC-ALL-2005 protocol, showed that the 10-year-EFS and 10-year-overall survival of the SCMC-ALL-2009 protocol were better than that of the -2005 protocol. Notably, the intermediate-risk group was improved after the chemotherapy intensity was strengthened.
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