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在前体B细胞和T细胞急性淋巴细胞白血病中,EORTC儿童白血病组前性研究58081的结果

Carine Domenech¹, Michal Kicinski², Barbara De Moerloose³

¹Department of Pediatric Hematology-Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon Université Lyon1 Lyon France.

|November 14, 2024

概括

这项研究比较了儿童中两种急性淋巴细胞白血病治疗方案. 使用德甲的修改方案显示出改善的结果,特别是在T-ALL和平均风险2组.

科学领域:

儿科瘤学儿科瘤学
血液学血液学血液学
临床试验临床试验

背景情况:

针对儿科急性淋巴细胞白血病 (ALL) 的治疗建议是基于EORTC-CLG 58951试验.
EORTC-CLG 58081研究旨在评估与58951对照组相比修改后的治疗方案.

研究的目的:

报告前性队列研究EORTC-CLG 58081.1.的结果.
为了将修改后的BFM骨干协议的结果与儿科ALL患者的已建立的EORTC-CLG 58951试验进行比较.

主要方法:

前性队列研究 (EORTC-CLG 58081) 和与随机第三期试验 (EORTC-CLG 58951) 的比较.
1至18岁的BCR::ABL1阴性B系 (B-ALL) 和T系 (T-ALL) 患者在没有皮辐射的情况下接受治疗.
修改包括在平均风险的2 (AR2) T-ALL和B-ALL中使用德克萨米他,延迟白素救援,以及额外的MRD分层时间点.

主要成果:

总体5年无事件生存 (EFS) 在研究之间是相似的 (84.8% vs 83.6%).
在B-ALL中,EFS是可比的 (84.3%和84.9%).
在T-ALL中,58081的研究显示了更高的EFS (87.3%vs76.6%).
风险组比较显示了显著的差异,在58081研究中,AR2患者的EFS更好 (HR 0.34),在非常低风险患者的EFS更差 (HR 2.15).

结论:

在EORTC-CLG 58081中修改后的协议显示了有利的结果,特别是在T-ALL和AR2子组.
在特定的患者群体中使用德克萨米他似乎是有益的.
风险分层对于优化儿科ALL治疗策略至关重要.

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