BACKGROUND: We report on the treatment of children and adolescents with acute lymphoblastic leukemia (ALL) in first relapse. The protocol focused on: (1) Intensive chemotherapy preceding allogeneic stem cell transplantation (SCT) in early bone marrow relapse; (2) Rotational chemotherapy in late relapse, without donor; (3) Postponement of cerebro-spinal irradiation in late isolated CNS relapse; and (4) Treatment in very late bone marrow relapse with chemotherapy only. METHODS: From January 1999 until July 2006 all 158 Dutch pediatric patients with ALL in first relapse were recorded. Ninety-nine patients were eligible; 54 patients with early and 45 with late relapse. Eighteen patients had an isolated extra-medullary relapse; 69 patients had bone marrow involvement only. RESULTS: Five-years EFS rates for early and late relapses were 12% and 35%, respectively. For early relapses 5 years EFSs were 25% for patients transplanted; 0% for non-transplanted patients. For late relapses 5 years EFS was 64% for patients treated with chemotherapy only, and 16% for transplanted patients. For very late relapses EFS was 58%. CONCLUSIONS: Our data suggest the superiority of SCT for early relapse patients. For late relapses a better outcome is achieved with chemotherapy only using the rotational chemotherapy scheme. The most important factor for survival was interval between first CR and occurrence of the first relapse.
BACKGROUND: We report on the treatment of children and adolescents with acute lymphoblastic leukemia (ALL) in first relapse. The protocol focused on: (1) Intensive chemotherapy preceding allogeneic stem cell transplantation (SCT) in early bone marrow relapse; (2) Rotational chemotherapy in late relapse, without donor; (3) Postponement of cerebro-spinal irradiation in late isolated CNS relapse; and (4) Treatment in very late bone marrow relapse with chemotherapy only. METHODS: From January 1999 until July 2006 all 158 Dutch pediatric patients with ALL in first relapse were recorded. Ninety-nine patients were eligible; 54 patients with early and 45 with late relapse. Eighteen patients had an isolated extra-medullary relapse; 69 patients had bone marrow involvement only. RESULTS: Five-years EFS rates for early and late relapses were 12% and 35%, respectively. For early relapses 5 years EFSs were 25% for patients transplanted; 0% for non-transplanted patients. For late relapses 5 years EFS was 64% for patients treated with chemotherapy only, and 16% for transplanted patients. For very late relapses EFS was 58%. CONCLUSIONS: Our data suggest the superiority of SCT for early relapse patients. For late relapses a better outcome is achieved with chemotherapy only using the rotational chemotherapy scheme. The most important factor for survival was interval between first CR and occurrence of the first relapse.
Authors: Laura E Hogan; Julia A Meyer; Jun Yang; Jinhua Wang; Nicholas Wong; Wenjian Yang; Gregory Condos; Stephen P Hunger; Elizabeth Raetz; Richard Saffery; Mary V Relling; Deepa Bhojwani; Debra J Morrison; William L Carroll Journal: Blood Date: 2011-09-14 Impact factor: 22.113
Authors: Stephen P Hunger; Mignon L Loh; James A Whitlock; Naomi J Winick; William L Carroll; Meenakshi Devidas; Elizabeth A Raetz Journal: Pediatr Blood Cancer Date: 2012-12-19 Impact factor: 3.167
Authors: Smita Dandekar; Eleny Romanos-Sirakis; Faye Pais; Teena Bhatla; Courtney Jones; Wallace Bourgeois; Stephen P Hunger; Elizabeth A Raetz; Michelle L Hermiston; Ramanuj Dasgupta; Debra J Morrison; William L Carroll Journal: Br J Haematol Date: 2014-07-04 Impact factor: 6.998
Authors: F V Castro; O J McGinn; S Krishnan; G Marinov; J Li; A J Rutkowski; E Elkord; D J Burt; M Holland; R Vaghjiani; A Gallego; V Saha; P L Stern Journal: Leukemia Date: 2012-01-23 Impact factor: 11.528
Authors: Francesco Ceppi; Michel Duval; Jean-Marie Leclerc; Caroline Laverdiere; Yves-Line Delva; Sonia Cellot; Pierre Teira; Henrique Bittencourt Journal: PLoS One Date: 2016-09-15 Impact factor: 3.240
Authors: Frederick W Thielen; Annemieke van Dongen-Leunis; Alexander M M Arons; Judith R Ladestein; Peter M Hoogerbrugge; Carin A Uyl-de Groot Journal: Eur J Haematol Date: 2020-05-04 Impact factor: 2.997