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

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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 - Dec 1 2000

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Disease-Free Survival
Survival Rate
Central Nervous System
Leukocyte Count
Research
Recurrence
Therapeutics
Karyotype
Leukemia
Age Groups
Clinical Trials

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine

Cite this

Pui, C. H., Boyett, J. M., Rivera, G. K., Hancock, M. L., Sandlund, J. T., Ribeiro, R. C., ... 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

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

In: Leukemia, Vol. 14, No. 12, 01.12.2000, p. 2286-2294.

Research output: Contribution to journalArticle

Pui, CH, Boyett, JM, Rivera, GK, Hancock, ML, Sandlund, JT, Ribeiro, RC, Rubnitz, JE, Behm, FG, Raimondi, SC, Gajjar, A, Razzouk, B, Campana, D, Kun, LE, Relling, MV & Evans, WE 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, vol. 14, no. 12, pp. 2286-2294. https://doi.org/10.1038/sj.leu.2401938
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. / Long-term results of total therapy studies 11, 12 and 13A for childhood acute lymphoblastic leukemia at St Jude children's research hospital. In: Leukemia. 2000 ; Vol. 14, No. 12. pp. 2286-2294.
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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.",
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AU - Sandlund, J. T.

AU - Ribeiro, R. C.

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AU - Raimondi, S. C.

AU - Gajjar, A.

AU - Razzouk, B.

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N2 - 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.

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