BACKGROUND: In the ALL-BFM 95 trial for treatment of acute lymphoblastic leukemia, response to a prednisone pre-phase (prednisone response) was used for risk stratification in combination with age and white blood cell count at diagnosis, response to induction therapy and specific genetic high-risk features. DESIGN AND METHODS: Cytomorphological marrow response was prospectively assessed on Day 15 during induction, and its prognostic value was analyzed in 1,431 patients treated on ALL-BFM 95. RESULTS: The 8-year probabilities of event-free survival were 86.1%, 74.5%, and 46.4% for patients with M1, M2, and M3 Day 15 marrows, respectively. Compared to prednisone response, Day 15 marrow response was superior in outcome prediction in precursor B-cell and T-cell leukemia with, however, a differential effect depending on blast lineage. Outcome was poor in T-cell leukemia patients with prednisone poor-response independent of Day 15 marrow response, whereas among patients with prednisone good-response different risk groups could be identified by Day 15 marrow response. In contrast, prednisone response lost prognostic significance in precursor B-cell leukemia when stratified by Day 15 marrow response. Age and white blood cell count retained their independent prognostic effect. CONCLUSIONS: Selective addition of Day 15 marrow response to conventional stratification criteria applied on ALL-BFM 95 (currently in use in several countries as regular chemotherapy protocol for childhood acute lymphoblastic leukemia) may significantly improve risk-adapted treatment delivery. Even though cutting-edge trial risk stratification is meanwhile dominated by minimal residual disease evaluation, an improved conventional risk assessment, as presented here, could be of great importance to countries that lack the technical and/or financial resources associated with the application of minimal residual disease analysis.
BACKGROUND: In the ALL-BFM 95 trial for treatment of acute lymphoblastic leukemia, response to a prednisone pre-phase (prednisone response) was used for risk stratification in combination with age and white blood cell count at diagnosis, response to induction therapy and specific genetic high-risk features. DESIGN AND METHODS: Cytomorphological marrow response was prospectively assessed on Day 15 during induction, and its prognostic value was analyzed in 1,431 patients treated on ALL-BFM 95. RESULTS: The 8-year probabilities of event-free survival were 86.1%, 74.5%, and 46.4% for patients with M1, M2, and M3 Day 15 marrows, respectively. Compared to prednisone response, Day 15 marrow response was superior in outcome prediction in precursor B-cell and T-cell leukemia with, however, a differential effect depending on blast lineage. Outcome was poor in T-cell leukemiapatients with prednisone poor-response independent of Day 15 marrow response, whereas among patients with prednisone good-response different risk groups could be identified by Day 15 marrow response. In contrast, prednisone response lost prognostic significance in precursor B-cell leukemia when stratified by Day 15 marrow response. Age and white blood cell count retained their independent prognostic effect. CONCLUSIONS: Selective addition of Day 15 marrow response to conventional stratification criteria applied on ALL-BFM 95 (currently in use in several countries as regular chemotherapy protocol for childhood acute lymphoblastic leukemia) may significantly improve risk-adapted treatment delivery. Even though cutting-edge trial risk stratification is meanwhile dominated by minimal residual disease evaluation, an improved conventional risk assessment, as presented here, could be of great importance to countries that lack the technical and/or financial resources associated with the application of minimal residual disease analysis.
Authors: M Dördelmann; A Reiter; A Borkhardt; W D Ludwig; N Götz; S Viehmann; H Gadner; H Riehm; M Schrappe Journal: Blood Date: 1999-08-15 Impact factor: 22.113
Authors: A Thyss; S Suciu; Y Bertrand; F Mazingue; A Robert; E Vilmer; F Mechinaud; Y Benoit; P Brock; A Ferster; P Lutz; P Boutard; G Marguerite; E Plouvier; G Michel; D Plantaz; M Munzer; X Rialland; J M Chantraine; L Norton; G Solbu; N Philippe; J Otten Journal: J Clin Oncol Date: 1997-05 Impact factor: 44.544
Authors: Yousif Matloub; Susan Lindemulder; Paul S Gaynon; Harland Sather; Mei La; Emmett Broxson; Rochelle Yanofsky; Raymond Hutchinson; Nyla A Heerema; James Nachman; Marilyn Blake; Linda M Wells; April D Sorrell; Margaret Masterson; John F Kelleher; Linda C Stork Journal: Blood Date: 2006-04-11 Impact factor: 22.113
Authors: P S Gaynon; A A Desai; B C Bostrom; R J Hutchinson; B J Lange; J B Nachman; G H Reaman; H N Sather; P G Steinherz; M E Trigg; D G Tubergen; F M Uckun Journal: Cancer Date: 1997-11-01 Impact factor: 6.860
Authors: M Aricò; G Basso; F Mandelli; C Rizzari; R Colella; E Barisone; L Zanesco; R Rondelli; A Pession; G Masera Journal: Cancer Date: 1995-04-01 Impact factor: 6.860
Authors: J J van Dongen; T Seriu; E R Panzer-Grümayer; A Biondi; M J Pongers-Willemse; L Corral; F Stolz; M Schrappe; G Masera; W A Kamps; H Gadner; E R van Wering; W D Ludwig; G Basso; M A de Bruijn; G Cazzaniga; K Hettinger; A van der Does-van den Berg; W C Hop; H Riehm; C R Bartram Journal: Lancet Date: 1998-11-28 Impact factor: 79.321
Authors: M Smith; D Arthur; B Camitta; A J Carroll; W Crist; P Gaynon; R Gelber; N Heerema; E L Korn; M Link; S Murphy; C H Pui; J Pullen; G Reamon; S E Sallan; H Sather; J Shuster; R Simon; M Trigg; D Tubergen; F Uckun; R Ungerleider Journal: J Clin Oncol Date: 1996-01 Impact factor: 44.544
Authors: P G Steinherz; P S Gaynon; J C Breneman; J M Cherlow; N J Grossman; J H Kersey; H S Johnstone; H N Sather; M E Trigg; R Chappell; D Hammond; W A Bleyer Journal: J Clin Oncol Date: 1996-02 Impact factor: 44.544
Authors: Jayakumar Vadakekolathu; Mark D Minden; Tressa Hood; Sarah E Church; Stephen Reeder; Heidi Altmann; Amy H Sullivan; Elena J Viboch; Tasleema Patel; Narmin Ibrahimova; Sarah E Warren; Andrea Arruda; Yan Liang; Thomas H Smith; Gemma A Foulds; Michael D Bailey; James Gowen-MacDonald; John Muth; Marc Schmitz; Alessandra Cesano; A Graham Pockley; Peter J M Valk; Bob Löwenberg; Martin Bornhäuser; Sarah K Tasian; Michael P Rettig; Jan K Davidson-Moncada; John F DiPersio; Sergio Rutella Journal: Sci Transl Med Date: 2020-06-03 Impact factor: 17.956
Authors: Lauren K Meyer; Benjamin J Huang; Cristina Delgado-Martin; Ritu P Roy; Aaron Hechmer; Anica M Wandler; Tiffaney L Vincent; Paolo Fortina; Adam B Olshen; Brent L Wood; Terzah M Horton; Kevin M Shannon; David T Teachey; Michelle L Hermiston Journal: J Clin Invest Date: 2020-02-03 Impact factor: 14.808
Authors: Michael J Burke; Michael R Verneris; Jennifer Le Rademacher; Wensheng He; Hisham Abdel-Azim; Allistair A Abraham; Jeffery J Auletta; Mouhab Ayas; Valerie I Brown; Mitchell S Cairo; Ka Wah Chan; Miguel A Diaz Perez; Christopher C Dvorak; R Maarten Egeler; Lamis Eldjerou; Haydar Frangoul; Gregory M T Guilcher; Robert J Hayashi; Ahmed Ibrahim; Kimberly A Kasow; Wing H Leung; Richard F Olsson; Michael A Pulsipher; Niketa Shah; Nirali N Shah; Elizabeth Thiel; Julie-An Talano; Carrie L Kitko Journal: Biol Blood Marrow Transplant Date: 2015-08-29 Impact factor: 5.742
Authors: Nicholas J Short; Hagop M Kantarjian; Koji Sasaki; Jorge E Cortes; Farhad Ravandi; Deborah A Thomas; Guillermo Garcia-Manero; Issa Khouri; Partow Kebriaei; Richard E Champlin; Sherry Pierce; Ghayas C Issa; Marina Konopleva; Tapan M Kadia; Carlos Bueso-Ramos; Joseph D Khoury; Nitin Jain; Susan M O'Brien; Elias Jabbour Journal: Cancer Date: 2016-08-10 Impact factor: 6.860
Authors: Jordy C G van der Zwet; Jessica G C A M Buijs-Gladdines; Valentina Cordo'; Donna O Debets; Willem K Smits; Zhongli Chen; Jelle Dylus; Guido J R Zaman; Maarten Altelaar; Koichi Oshima; Beat Bornhauser; Jean-Pierre Bourquin; Jan Cools; Adolfo A Ferrando; Josef Vormoor; Rob Pieters; Britta Vormoor; Jules P P Meijerink Journal: Leukemia Date: 2021-05-18 Impact factor: 11.528
Authors: D Da Costa; A Agathanggelou; T Perry; V Weston; E Petermann; A Zlatanou; C Oldreive; W Wei; G Stewart; J Longman; E Smith; P Kearns; S Knapp; T Stankovic Journal: Blood Cancer J Date: 2013-07-19 Impact factor: 11.037
Authors: Melissa A Burns; Andrew E Place; Kristen E Stevenson; Alejandro Gutiérrez; Suzanne Forrest; Yana Pikman; Lynda M Vrooman; Marian H Harris; Sarah K Hunt; Jane E O'Brien; Barbara L Asselin; Uma H Athale; Luis A Clavell; Peter D Cole; Lisa M Gennarini; Justine M Kahn; Kara M Kelly; Caroline Laverdiere; Jean-Marie Leclerc; Bruno Michon; Marshall A Schorin; Maria Luisa Sulis; Jennifer J G Welch; Donna S Neuberg; Stephen E Sallan; Lewis B Silverman Journal: Pediatr Blood Cancer Date: 2020-10-07 Impact factor: 3.167