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Improved therapy for children with acute lymphoblastic leukemia
Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie
|January 1, 1996
Summary
Treatment for childhood B-precursor acute lymphoblastic leukemia (ALL) has improved, with over 85% 4-year event-free survival (EFS) in average-risk patients. High-risk groups still face challenges, necessitating further research into prognostic factors.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Trials
Background:
- Japanese children with B-precursor acute lymphoblastic leukemia (ALL) have been treated in consecutive chemotherapeutic trials.
- Treatment results have steadily improved over time, particularly for children with average presenting features.
Purpose of the Study:
- To examine factors influencing clinical prognosis in Japanese children with B-precursor ALL.
- To assess treatment outcomes and identify prognostic indicators for improved patient management.
Main Methods:
- Analysis of data from consecutive chemotherapeutic trials conducted between 1976 and 1995.
- Evaluation of presenting features such as age and leukocyte counts to stratify patients into risk groups.
Main Results:
- The 4-year event-free survival (EFS) now exceeds 85% for children with average presenting features.
- High-dose methotrexate and intrathecal therapy replaced cranial irradiation without increasing central nervous system relapse.
- Children with unfavorable presenting features (high-risk group) have a worse prognosis, with a 4-year EFS rate better than 60%.
Conclusions:
- Significant treatment improvements have been achieved for childhood ALL in Japan.
- Further investigation into biological prognostic factors is needed to identify high-risk patients.
- For chemotherapy-resistant cases, the benefits of intensive treatments like bone marrow transplantation may outweigh risks.