Efficiency of the ALL-MB-2002 protocol in children with acute lymphoblastic leukemia

Yu V Rumyantseva; Румянцева Ю В; A I Karachunsky; Карачунский Александр Исаакович; O V Aleinikova; Алейникова О В; L G Fechina; Фечина Л Г; A V Shamardina; Шамардина А В; D V Litvinov; Литвинов Д В; N I Ponomareva; Пономарева Н И; E G Boichenko; Бойченко Э Г; S A Dudkin; Дудкин С А; O V Streneva; Стренева О В; K L Kondratchik; Кондратчик К Л; E G Mansurova; Мансурова Е Г; L M Minkina; Минкина Л М; E S Lapotentova; Лапотентова Е С; E V Inyushkina; Инюшкина Е В; N B Yudina; Юдина Н Б; G P Pavlova; Павлова Г П; E V Zhukovskaya; Жуковская Е В; O P Khlebnikova; Хлебникова О П; S N Lagoiko; Лагойко С Н; E V Basharova; Башарова Е В; R E Denisov; Денисов Р Э; V D Zlobina; Злобина В Д; E S Banshchikova; Банщикова Е С; K S Aslanyan; Асланян К С; E V Kondakova; Кондакова Е В; E V Tselousova; Целоусова Е В; N V Myakova; Мякова Н В; T V Turobova; Туробова Т В; O V Ryskal; Рыскаль О В; N F Chipsanova; Чипсанова Н Ф; S R Varfolomeyeva; Варфоломеева С Р; A G Rumyantsev; Румянцев А Г

Efficiency of the ALL-MB-2002 protocol in children with acute lymphoblastic leukemia

Authors: Rumyantseva Y.V¹, Karachunsky AI¹, Aleinikova OV², Fechina LG³, Shamardina AV⁴, Litvinov DV⁵, Ponomareva NI⁵, Boichenko EG⁶, Dudkin SA⁷, Streneva OV³, Kondratchik KL⁸, Mansurova EG¹, Minkina LM⁹, Lapotentova ES², Inyushkina EV¹⁰, Yudina NB¹¹, Pavlova GP¹², Zhukovskaya EV¹³, Khlebnikova OP³, Lagoiko SN¹, Basharova EV¹³, Denisov RE¹³, Zlobina VD¹⁴, Banshchikova ES¹⁵, Aslanyan KS¹⁶, Kondakova EV¹⁷, Tselousova EV¹⁸, Myakova NV⁵, Turobova TV¹⁹, Ryskal OV²⁰, Chipsanova NF²¹, Varfolomeyeva SR¹, Rumyantsev AG¹
Affiliations:
1. Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow
2. Republican Research and Practical Center of Pediatric Oncology and Hematology, Minsk, Belarus
3. Center of Oncology and Hematology, Regional Children's Hospital One, Yekaterinburg
4. Regional Children's Hospital, Nizhni Novgorod
5. Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, MoscowRepublican Children's Hospital, Moscow
6. Children's Hospital One, Saint Petersburg
7. Town Children's Hospital Four, Novokuznetsk
8. Morozov City Children's Hospital, Moscow
9. Children's Town Hospital, Vladivostok
10. Moscow Regional Cancer Dispensary, Balashikha, Moscow Region
11. Regional Children's Hospital One, Voronezh
12. Regional Children's Hospital, Ministry of Health and Social Development of Chuvash Republic, Cheboksary
13. Regional Children's Hospital, Chelyabinsk
14. Central District Hospital, Novosibirsk
15. Regional Hospital One - NCM (National Center of Medicine), Yakutsk
16. Regional Children's Hospital, Rostov-on-Don
17. Surgut District Hospital, UHMAU-Ugry, Surgut
18. Kirov Research Institute of Hematology and Blood Transfusion
19. Regional Children's Hospital, Arkhangelsk
20. Regional Children's Hospital, Perm
21. Komi Republican Cardiology Dispensary, Syktyvkar
Issue: Vol 82, No 7 (2010)
Pages: 11-19
Section: Editorial
URL: https://ter-arkhiv.ru/0040-3660/article/view/30592

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Aim. To evaluate the efficiency of the original ALL-MB-2002 protocol within the multicenter study of treatment of acute lymphoblastic leukemia (ALL) in children.
Subjects and methods. A total of 1873 primary patients with ALL aged 1 to 18 years, of whom 1544 patients were enrolled in this study, were notified at 36 clinics of Russia and Belarus from April 15, 2002, to January 1, 2008.
Results. With the median observation of 4.12 years, 7-year event-free survival (EFS) was 73±13%; overall survival (OS) 78±2%; relapse-free survival 82±1%. The rates of EFS and OS were equal and amounted to 76±2 and 80±2% in the standard-risk group (SRG) and intermediate-risk group (ImRG), respectively. In the high-risk group (HRG) patients, EFS and OS were as high as 30±6 and 37±6%, respectively. The frequency of relapses with central nervous system lesion was as much as 4.7% in all the patients, 6-year cumulative risk for isolated neurorecurrences being 2.5% in the SRG patients. Adolescents, patients with the baseline leukocytosis (more than 100109/l), and those with a splenic size of over 4 cm or more from the costal arch margin had substantially worse survival rates. A poor early response to therapy (on induction days 8 and 15) was also associated with its lower efficiency.
Conclusion. Despite a considerable rise in the number of centers and a slight increase in the intensity of therapy, the results of the new ALL-MB-2002 protocol are as minimum equivalents obtained in the use of the previous ALL-MB-91 protocol. A significant improvement in the overall results of therapy and a reduction in the cumulative risk for isolated neurorecurrences were noted in the ImRG patients.

Keywords

acute lymphoblastic leukemia, children, efficiency of therapy

References

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Efficiency of the ALL-MB-2002 protocol in children with acute lymphoblastic leukemia

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