Long-term results of Tokyo Children's Cancer Study Group trials for childhood acute lymphoblastic leukemia, 1984–1999

被引：0

作者：

M Tsuchida

A Ohara

A Manabe

M Kumagai

H Shimada

A Kikuchi

T Mori

M Saito

M Akiyama

T Fukushima

K Koike

M Shiobara

C Ogawa

T Kanazawa

Y Noguchi

S Oota

Y Okimoto

H Yabe

M Kajiwara

D Tomizawa

K Ko

K Sugita

T Kaneko

M Maeda

T Inukai

H Goto

H Takahashi

K Isoyama

Y Hayashi

R Hosoya

R Hanada

机构：

[1] Ibaraki Children's Hospital,Department of Pediatric Hematology and Oncology

[2] Toho University Medical Center,Department of First Pediatrics

[3] Oomori Hospital,Department of Pediatrics

[4] St Luke's International Hospital,Department of Pediatric Hematology/Oncology

[5] National Center for Child Health and Development,Department of Pediatrics

[6] Keio University,Department of Pediatrics

[7] School of Medicine,Department of Pediatrics

[8] Faculty of Medicine,Department of Pediatrics

[9] University of Tokyo,Department of Pediatrics

[10] Juntendo University,Departments of Pediatrics

[11] School of Medicine,Department of Pediatrics

[12] Tokyo Jikei University,Department of Pediatrics

[13] School of Medicine,Department of Pediatrics

[14] School of Medicine,Department of Hematology/Oncology

[15] University of Tsukuba,Department of Pediatrics and Blood Transfusion

[16] University of Shinshu,Department of Pediatrics

[17] School of Medicine,Department of Hematology/Oncology

[18] Gumma University,Department of Pediatrics

[19] School of Medicine,Department of Hematology/Oncology

[20] Japanese Red Cross Narita Hospital,Department of Pediatrics

[21] Chiba Medical Center,Department of Pediatrics

[22] Teikyo University,Department of Pediatrics

[23] Chiba Children's Hospital,Department of Pediatrics

[24] Tokai University,Department of Pediatrics

[25] School of Medicine,Department of Hematology/Oncology

[26] Tokyo Medical and Dental University,undefined

[27] School of Medicine,undefined

[28] Saitama Children's Medical Center,undefined

[29] Dokkyo Medical University,undefined

[30] Tokyo Metropolitan Kiyose Children's Hospital,undefined

[31] Nippon Medical University,undefined

[32] University of Yamanashi,undefined

[33] School of Medicine,undefined

[34] Yokohama City University,undefined

[35] School of Medicine,undefined

[36] Yokohama Saiseikai Nanbu Hospital,undefined

[37] Showa University,undefined

[38] School of Medicine,undefined

[39] Fujigaoka Hospital,undefined

[40] Gunma Children's Hospital,undefined

来源：

Leukemia | 2010年 / 24卷

关键词：

acute lymphoblastic leukemia; children; long-term results; cranial irradiation; secondary malignancy;

D O I：

暂无

中图分类号：

学科分类号：

摘要：

We report the long-term results of Tokyo Children's Cancer Study Group's studies L84-11, L89-12, L92-13, and L95-14 for 1846 children with acute lymphoblastic leukemia, which were conducted between 1984 and 1999. The value of event-free survival (EFS)±s.e. was 67.2±2.2% at 10 years in L84-11, which was not improved in the following two studies, and eventually improved to 75.0±1.8% at 10 years in L95-14 study. The lower EFS of the L89-12 reflected a high rate of induction failure because of infection and delayed remission in very high-risk patients. The L92-13 study was characterized by short maintenance therapy; it resulted in poor EFS, particularly in the standard-risk (SR) group and boys. Females did significantly better than males in EFS in the early three studies. The gender difference was not significant in overall survival, partly because >60% of the males survived after the testicular relapse. Randomized studies in the former three protocols revealed that intermediate- or high-dose methotrexate therapy significantly reduced the testicular relapse rate. In the L95-14 study, gender difference disappeared in EFS. Contrary to the results of larger-scale studies, the randomized control study in the L95-14 reconfirmed with updated data that dexamethasone 8 mg/m2 had no advantage over prednisolone 60 mg/m2 in the SR and intermediate-risk groups. Prophylactic cranial irradiation was assigned to 100, 80, 44, and 44% of the patients in the studies, respectively. Isolated central nervous system relapse rates decreased to <2% in the last two trials. Secondary brain tumors developed in 12 patients at 8–22 years after cranial irradiation. Improvement of the remission induction rates and the complete omission of irradiation are currently main objectives in our studies.

引用

页码：383 / 396

页数：13

共 229 条

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[8] Akatsuka J(1995)Extended intrathecal methotrexate may replace cranial irradiation for prevention of CNS relapse in children with intermediate-risk acute lymphoblastic leukemia treated with Berlin-Frankfurt-Münster-based intensive chemotherapy. The Associazione Italiana di Ematologia ed Oncologia Pediatrica J Clin Oncol 13 2497-2502
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