BACKGROUND: Approximately 25% of children newly diagnosed with acute lymphoblastic leukemia (ALL) will eventually experience leukemic relapse, with bone marrow being the most common site of recurrence. The ability to achieve a durable second remission is complicated by toxicity and resistant disease. We report a novel combination of chemotherapy for relapsed pediatric ALL. PROCEDURE: Thirty pediatric patients with relapsed medullary (n = 18) and extra-medullary (n = 12) ALL were enrolled at three pediatric institutions. Following receipt of induction and the first Block A and Block B of intensification, each patient was evaluated for toxicity, efficacy in achieving remission, and long-term survival. Additionally, minimal residual disease (MRD) detection by multidimensional flow cytometry (MDF) was performed. RESULTS: During induction, the major non-hematopoeitic toxicities were mucositis (30% of patients) and bacteremia (50% of patients). Two patients (7%) died of toxicity during induction. Toxicity during intensification Block 1A and 1B was markedly reduced. Eight-nine percent of patients with marrow disease achieved a remission following induction and intensification. The event-free survival (EFS) for all patients at 2 and 4 years were 60% (95% CI: 42-78%) and 49% (95% CI: 30-68%), respectively. CONCLUSIONS: This regimen for patients with relapsed ALL was successful in achieving a second remission for the majority of patients with acceptable toxicity. Copyright 2004 Wiley-Liss, Inc.
BACKGROUND: Approximately 25% of children newly diagnosed with acute lymphoblastic leukemia (ALL) will eventually experience leukemic relapse, with bone marrow being the most common site of recurrence. The ability to achieve a durable second remission is complicated by toxicity and resistant disease. We report a novel combination of chemotherapy for relapsed pediatric ALL. PROCEDURE: Thirty pediatric patients with relapsed medullary (n = 18) and extra-medullary (n = 12) ALL were enrolled at three pediatric institutions. Following receipt of induction and the first Block A and Block B of intensification, each patient was evaluated for toxicity, efficacy in achieving remission, and long-term survival. Additionally, minimal residual disease (MRD) detection by multidimensional flow cytometry (MDF) was performed. RESULTS: During induction, the major non-hematopoeitic toxicities were mucositis (30% of patients) and bacteremia (50% of patients). Two patients (7%) died of toxicity during induction. Toxicity during intensification Block 1A and 1B was markedly reduced. Eight-nine percent of patients with marrow disease achieved a remission following induction and intensification. The event-free survival (EFS) for all patients at 2 and 4 years were 60% (95% CI: 42-78%) and 49% (95% CI: 30-68%), respectively. CONCLUSIONS: This regimen for patients with relapsed ALL was successful in achieving a second remission for the majority of patients with acceptable toxicity. Copyright 2004 Wiley-Liss, Inc.
Authors: Weili Sun; Etan Orgel; Jemily Malvar; Richard Sposto; Jennifer J Wilkes; Rebecca Gardner; Vanessa P Tolbert; Alison Smith; Minjun Hur; Jill Hoffman; Susan R Rheingold; Michael J Burke; Alan S Wayne Journal: Pediatr Blood Cancer Date: 2016-07-20 Impact factor: 3.167
Authors: Robert S Nickel; Frank Keller; John Bergsagel; Todd Cooper; Marla Daves; Himalee Sabnis; Glen Lew Journal: Pediatr Blood Cancer Date: 2013-12-19 Impact factor: 3.167
Authors: Sarah Alexander; Michael Nieder; Danielle M Zerr; Brian T Fisher; Christopher C Dvorak; Lillian Sung Journal: Pediatr Blood Cancer Date: 2011-11-18 Impact factor: 3.167
Authors: Elizabeth A Raetz; Michael J Borowitz; Meenakshi Devidas; Stephen B Linda; Stephen P Hunger; Naomi J Winick; Bruce M Camitta; Paul S Gaynon; William L Carroll Journal: J Clin Oncol Date: 2008-08-20 Impact factor: 44.544