Long-term results of total therapy studies 11, 12 and 13A for childhood acute lymphoblastic leukemia at St Jude children's research hospital

C. H. Pui, J. M. Boyett, G. K. Rivera, M. L. Hancock, J. T. Sandlund, R. C. Ribeiro, J. E. Rubnitz, F. G. Behm, S. C. Raimondi, A. Gajjar, B. Razzouk, D. Campana, L. E. Kun, M. V. Relling, W. E. Evans

Research output: Contribution to journalArticle

170 Scopus citations

Abstract

We present the long-term results of three consecutive clinical trials (Total Therapy studies 11, 12 and 13A) conducted for children with newly diagnosed acute lymphoblastic leukemia (ALL) between 1984 and 1994. In study 11 (1984-1988), the overall event-free survival rates (±1 s.e.) were 71.8 ± 2.4% and 69.3 ± 2.4%, and the cumulative risks of isolated central nervous system (CNS) relapse 5.6 ± 1.2% and 5.9 ± 1.3%, at 5 and 10 years, respectively. In study 12 (1988-1991), event-free survival rates were 67.6 ± 3.4% and 61.5 ± 9.0%, and isolated CNS relapse rates were 10.4 ± 2.3% and 10.4 ± 2.3%, respectively. Early intensive intrathecal therapy in study 13A (1991-1994) has yielded a very low 5-year isolated CNS relapse rate of 1.2 ± 0.9%, boosting the 5-year event-free survival rate to 76.9 ± 3.3%. Factors consistently associated with an adverse prognosis included male sex, infant or adolescent age group, leukocyte count > 100 × 109/l, nonhyperdiploidy karyotype and poor early response to treatment. Risk classification based on age and leukocyte count had prognostic significance in B-lineage but not T-lineage ALL. Early therapeutic interventions or modifications for patients with specific genetic abnormalities or persistent minimal residual leukemia may further improve long-term results.

Original languageEnglish (US)
Pages (from-to)2286-2294
Number of pages9
JournalLeukemia
Volume14
Issue number12
DOIs
StatePublished - 2000

Keywords

  • B-lineage ALL
  • CNS relapse
  • Chemotherapy
  • Leukemia
  • Prognostic factors
  • T-lineage ALL

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Pui, C. H., Boyett, J. M., Rivera, G. K., Hancock, M. L., Sandlund, J. T., Ribeiro, R. C., Rubnitz, J. E., Behm, F. G., Raimondi, S. C., Gajjar, A., Razzouk, B., Campana, D., Kun, L. E., Relling, M. V., & Evans, W. E. (2000). Long-term results of total therapy studies 11, 12 and 13A for childhood acute lymphoblastic leukemia at St Jude children's research hospital. Leukemia, 14(12), 2286-2294. https://doi.org/10.1038/sj.leu.2401938