Determinants of survival after first relapse of acute lymphoblastic leukemia: a Children's Oncology Group study

被引：11

作者：

Rheingold, Susan R. ^{[1
,2
]}

Bhojwani, Deepa ^{[3
,4
]}

Ji, Lingyun ^{[5
]}

Xu, Xinxin ^{[6
]}

Devidas, Meenakshi ^{[7
]}

Kairalla, John A. ^{[8
]}

Shago, Mary ^{[9
]}

Heerema, Nyla A. ^{[10
]}

Carroll, Andrew J. ^{[11
]}

Breidenbach, Heather ^{[12
]}

Borowitz, Michael ^{[13
]}

Wood, Brent L. ^{[14
]}

Angiolillo, Anne L. ^{[15
]}

Asselin, Barbara L. ^{[16
]}

Bowman, W. Paul ^{[17
]}

Brown, Patrick ^{[18
]}

Dreyer, ZoAnn E. ^{[19
]}

Dunsmore, Kimberly P. ^{[20
]}

Hilden, Joanne M. ^{[21
,22
]}

Larsen, Eric ^{[23
]}

Maloney, Kelly ^{[21
,22
]}

Matloub, Yousif ^{[24
]}

Mattano, Leonard A. ^{[25
]}

Winter, Stuart S. ^{[26
]}

Gore, Lia ^{[21
,22
]}

Winick, Naomi J. ^{[27
]}

Carroll, William L. ^{[28
]}

Hunger, Stephen P. ^{[1
,2
]}

Raetz, Elizabeth A. ^{[28
]}

Loh, Mignon L. ^{[29
]}

机构：

[1] Univ Penn, Dept Pediat, Philadelphia, PA 19104 USA

[2] Univ Penn, Childrens Hosp Philadelphia, Ctr Childhood Canc Res, Perelman Sch Med, Philadelphia, PA 19104 USA

[3] Univ Southern Calif, Childrens Hosp Los Angeles, Norris Comprehens Canc Ctr, Div Pediat Hematol Oncol, Los Angeles, CA USA

[4] Univ Southern Calif, Keck Sch Med, Los Angeles, CA USA

[5] Univ Southern Calif, Keck Sch Med, Dept Populat & Publ Hlth Sci, Los Angeles, CA USA

[6] Childrens Oncol Grp, Monrovia, CA USA

[7] St Jude Childrens Res Hosp, Dept Global Pediat Med, Memphis, TN USA

[8] Univ Florida, Dept Biostat, Gainesville, FL USA

[9] Univ Toronto, Hosp Sick Children, Dept Lab Med & Pathobiol, Toronto, ON, Canada

[10] Ohio State Univ, Dept Pathol, Columbus, OH USA

[11] Univ Alabama Birmingham, Dept Genet, Birmingham, AL USA

[12] Hosp Sick Children, Toronto, ON, Canada

[13] Johns Hopkins Med Inst, Dept Pathol & Oncol, Baltimore, MD USA

[14] Univ Southern Calif, Childrens Hosp Los Angeles, Keck Sch Med, Dept Pathol & Lab Med, Los Angeles, CA USA

[15] Servier Pharmaceut, Boston, MA USA

[16] Univ Rochester, Golisano Childrens Hosp, Dept Pediat, Med Ctr,Wilmot Canc Ctr, Rochester, NY USA

[17] Cook Childrens Med Ctr, Ft Worth, TX USA

[18] Bristol Myers Squibb, Princeton, NJ USA

[19] Texas Childrens Hosp, Baylor Coll Med, Dept Pediat, Sect Hematol Oncol, Houston, TX USA

[20] Univ Virginia, Sch Med, Dept Pediat, Charlottesville, VA USA

[21] Univ Colorado, Sch Med, Dept Pediat, Aurora, CO USA

[22] Childrens Hosp Colorado, Ctr Canc & Blood Disorders, Aurora, CO USA

[23] Maine Med Ctr, Dept Pediat, Portland, ME USA

[24] Case Western Reserve Univ, Dept Pediat, Cleveland, OH USA

[25] HARP Pharm Consulting, Mystic, CT USA

[26] Childrens Minnesota, Canc & Blood Disorders Program, Minneapolis, MN USA

[27] Univ Texas Southwestern Med Ctr, Dept Pediat, Childrens Hlth, Dallas, TX USA

[28] NYU Grossman Sch Med, Dept Pediat, Perlmutter Canc Ctr, New York, NY USA

[29] Seattle Childrens Hosp, Dept Pediat, Seattle, WA USA

来源：

LEUKEMIA | 2024年

基金：

美国国家卫生研究院;

关键词：

ACUTE LYMPHOCYTIC-LEUKEMIA; MINIMAL RESIDUAL DISEASE; HIGH-DOSE METHOTREXATE; B-CELL PRECURSOR; HIGH-RISK; STANDARD-RISK; CLONAL ORIGINS; YOUNG-ADULTS; CHEMOTHERAPY; THERAPY;

D O I：

10.1038/s41375-024-02395-4

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Limited prognostic factors have been associated with overall survival (OS) post-relapse in childhood Acute Lymphoblastic Leukemia (ALL). Patients enrolled on 12 Children's Oncology Group frontline ALL trials (1996-2014) were analyzed to assess for additional prognostic factors associated with OS post-relapse. Among 16,115 patients, 2053 (12.7%) relapsed. Relapse rates were similar for B-ALL (12.5%) and T-ALL (11.2%) while higher for infants (34.2%). Approximately 50% of B-ALL relapses occurred late (>= 36 months) and 72.5% involved the marrow. Conversely, 64.8% of T-ALL relapses occurred early (<18 months) and 47.1% involved the central nervous system. The 5-year OS post-relapse for the entire cohort was 48.9 +/- 1.2%; B-ALL:52.5 +/- 1.3%, T-ALL:35.5 +/- 3.3%, and infant ALL:21.5 +/- 3.9%. OS varied by early, intermediate and late time-to-relapse; 25.8 +/- 2.4%, 49.5 +/- 2.2%, and 66.4 +/- 1.8% respectively for B-ALL and 29.8 +/- 3.9%, 33.3 +/- 7.6%, 58 +/- 9.8% for T-ALL. Patients with ETV6::RUNX1 or Trisomy 4 + 10 had median time-to-relapse of 43 months and higher OS post-relapse 74.4 +/- 3.1% and 70.2 +/- 3.6%, respectively. Patients with hypodiploidy, KMT2A-rearrangement, and TCF3::PBX1 had short median time-to-relapse (12.5-18 months) and poor OS post-relapse (14.2 +/- 6.1%, 31.9 +/- 7.7%, 36.8 +/- 6.6%). Site-of-relapse varied by cytogenetic subtype. This large dataset provided the opportunity to identify risk factors for OS post-relapse to inform trial design and highlight populations with dismal outcomes post-relapse.

引用

页码：2382 / 2394

页数：13

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