Outcome in Children With Standard-Risk B-Cell Acute Lymphoblastic Leukemia: Results of Children?s Oncology Group Trial AALL0331

被引：122

作者：

Maloney, Kelly W. ^{[1
,2
]}

Devidas, Meenakshi ^{[3
]}

Wang, Cindy ^{[4
]}

Mattano, Leonard A. ^{[5
]}

Friedmann, Alison M. ^{[6
]}

Buckley, Patrick ^{[7
]}

Borowitz, Michael J. ^{[8
]}

Carroll, Andrew J. ^{[9
]}

Gastier-Foster, Julie M. ^{[10
,11
,12
]}

Heerema, Nyla A. ^{[13
]}

Kadan-Lottick, Nina ^{[14
]}

Loh, Mignon L. ^{[15
,16
]}

Matloub, Yousif H. ^{[17
]}

Marshall, David T. ^{[18
]}

Stork, Linda C. ^{[19
]}

Raetz, Elizabeth A. ^{[20
,21
]}

Wood, Brent ^{[22
,23
]}

Hunger, Stephen P. ^{[24
,25
]}

Carroll, William L. ^{[20
,21
]}

Winick, Naomi J. ^{[26
,27
]}

机构：

[1] Univ Colorado, Dept Pediat, Aurora, CO USA

[2] Childrens Hosp Colorado, Aurora, CO USA

[3] St Jude Childrens Res Hosp, Dept Global Pediat Med, 332 N Lauderdale St, Memphis, TN 38105 USA

[4] Univ Florida, Dept Biostat, Colleges Med Publ Hlth & Hlth Profess, Gainesville, FL USA

[5] HARP Pharma Consulting, Mystic, CT USA

[6] Massachusetts Gen Hosp, Dept Pediat, Ctr Canc, Boston, MA 02114 USA

[7] Duke Univ, Med Ctr, Dept Pathol, Durham, NC 27710 USA

[8] Johns Hopkins Univ, Dept Pathol, Baltimore, MD USA

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

[10] Nationwide Childrens Hosp, Dept Pathol & Lab Med, Columbus, OH USA

[11] Ohio State Univ, Coll Med, Dept Pathol, Columbus, OH 43210 USA

[12] Ohio State Univ, Dept Pediat, Coll Med, Columbus, OH 43210 USA

[13] Ohio State Univ, Dept Pathol, Wexner Med Ctr, Columbus, OH 43210 USA

[14] Yale Univ, Dept Pediat, New Haven, CT 06520 USA

[15] Benioff Childrens Hosp, Dept Pediat, San Francisco, CA USA

[16] Univ Calif San Francisco, Helen Diller Family Comprehens Canc, San Francisco, CA 94143 USA

[17] Rainbow Babies & Childrens Hosp, Dept Pediat, Cleveland, OH 44106 USA

[18] Med Univ South Carolina, Dept Radiat Oncol, Charleston, SC 29425 USA

[19] Oregon Hlth & Sci Univ, Dept Pediat, 3181 Sw Sam Jackson Pk Rd, Portland, OR 97201 USA

[20] NYU, Langone Med Ctr, Perlmutter Canc Ctr, New York, NY USA

[21] NYU, Dept Pediat, Langone Med Ctr, New York, NY 10016 USA

[22] Univ Washington, Dept Pathol, Seattle, WA 98195 USA

[23] Univ Washington, Dept Med, Seattle, WA USA

[24] Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA

[25] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA

[26] Univ Texas UT Southwestern, Dept Pediat, Dallas, TX USA

[27] UT Southwestern, Simmons Canc Ctr, Dallas, TX USA

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2020年 / 38卷 / 06期

基金：

美国国家卫生研究院;

关键词：

MINIMAL RESIDUAL DISEASE; EVENT-FREE SURVIVAL; DELAYED INTENSIFICATION; YOUNG-ADULTS; UKALL; 2003; AIEOP-BFM; FOLLOW-UP; CHILDHOOD; THERAPY; DEXAMETHASONE;

D O I：

10.1200/JCO.19.01086

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PURPOSE Children?s Oncology Group (COG) AALL0331 tested whether intensified postinduction therapy that improves survival in children with high-risk B-cell acute lymphoblastic leukemia (ALL) would also improve outcomes for those with standard-risk (SR) ALL. PATIENTS AND METHODS AALL0331 enrolled 5,377 patients between 2005 and 2010. All patients received a 3-drug induction with dexamethasone, vincristine, and pegaspargase (PEG) and were then classified as SR low, SR average, or SR high. Patients with SR-average disease were randomly assigned to receive either standard 4-week consolidation (SC) or 8-week intensified augmented Berlin-Frankfurt-M?nster (BFM) consolidation (IC). Those with SR-high disease were nonrandomly assigned to the full COG-augmented BFM regimen, including 2 interim maintenance and delayed intensification phases. RESULTS The 6-year event-free survival (EFS) rate for all patients enrolled in AALL0331 was 88.96% ? 0.46%, and overall survival (OS) was 95.54% ? 0.31%. For patients with SR-average disease, the 6-year continuous complete remission (CCR) and OS rates for SC versus IC were 87.8% ? 1.3% versus 89.1% ? 1.2% (P = .52) and 95.8% ? 0.8% versus 95.2% ? 0.8% (P = 1.0), respectively. Those with SR-average disease with end-induction minimal residual disease (MRD) of 0.01% to < 0.1% had an inferior outcome compared with those with lower MRD and no improvement with IC (6-year CCR: SC, 77.5% ? 4.8%; IC, 77.1% ? 4.8%; P = .71). At 6 years, the CCR and OS rates among 635 nonrandomly treated patients with SR-high disease were 85.55% ? 1.49% and 92.97% ? 1.08%, respectively. CONCLUSION The 6-year OS rate for > 5,000 children with SR ALL enrolled in AALL0331 exceeded 95%. The addition of IC to treatment for patients with SR-average disease did not improve CCR or OS, even in patients with higher MRD, in whom it might have been predicted to provide more value. The EFS and OS rates are excellent for this group of patients with SR ALL, with particularly good outcomes for those with SR-high disease.

引用

页码：602 / +

页数：13

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