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

Abstract


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.

About the authors

Yu V Rumyantseva

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

A I Karachunsky

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

Email: aikarat@mail.ru, info@mbstudy.net
Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

O V Aleinikova

Republican Research and Practical Center of Pediatric Oncology and Hematology, Minsk, Belarus

Republican Research and Practical Center of Pediatric Oncology and Hematology, Minsk, Belarus

L G Fechina

Center of Oncology and Hematology, Regional Children's Hospital One, Yekaterinburg

Center of Oncology and Hematology, Regional Children's Hospital One, Yekaterinburg

A V Shamardina

Regional Children's Hospital, Nizhni Novgorod

Regional Children's Hospital, Nizhni Novgorod

D V Litvinov

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, MoscowRepublican Children's Hospital, Moscow

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, MoscowRepublican Children's Hospital, Moscow

N I Ponomareva

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, MoscowRepublican Children's Hospital, Moscow

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, MoscowRepublican Children's Hospital, Moscow

E G Boichenko

Children's Hospital One, Saint Petersburg

Children's Hospital One, Saint Petersburg

S A Dudkin

Town Children's Hospital Four, Novokuznetsk

Town Children's Hospital Four, Novokuznetsk

O V Streneva

Center of Oncology and Hematology, Regional Children's Hospital One, Yekaterinburg

Center of Oncology and Hematology, Regional Children's Hospital One, Yekaterinburg

K L Kondratchik

Morozov City Children's Hospital, Moscow

Morozov City Children's Hospital, Moscow

E G Mansurova

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

L M Minkina

Children's Town Hospital, Vladivostok

Children's Town Hospital, Vladivostok

E S Lapotentova

Republican Research and Practical Center of Pediatric Oncology and Hematology, Minsk, Belarus

Republican Research and Practical Center of Pediatric Oncology and Hematology, Minsk, Belarus

E V Inyushkina

Moscow Regional Cancer Dispensary, Balashikha, Moscow Region

Moscow Regional Cancer Dispensary, Balashikha, Moscow Region

N B Yudina

Regional Children's Hospital One, Voronezh

Regional Children's Hospital One, Voronezh

G P Pavlova

Regional Children's Hospital, Ministry of Health and Social Development of Chuvash Republic, Cheboksary

Regional Children's Hospital, Ministry of Health and Social Development of Chuvash Republic, Cheboksary

E V Zhukovskaya

Regional Children's Hospital, Chelyabinsk

Regional Children's Hospital, Chelyabinsk

O P Khlebnikova

Center of Oncology and Hematology, Regional Children's Hospital One, Yekaterinburg

Center of Oncology and Hematology, Regional Children's Hospital One, Yekaterinburg

S N Lagoiko

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

E V Basharova

Regional Children's Hospital, Chelyabinsk

Regional Children's Hospital, Chelyabinsk

R E Denisov

Regional Children's Hospital, Chelyabinsk

Regional Children's Hospital, Chelyabinsk

V D Zlobina

Central District Hospital, Novosibirsk

Central District Hospital, Novosibirsk

E S Banshchikova

Regional Hospital One - NCM (National Center of Medicine), Yakutsk

Regional Hospital One - NCM (National Center of Medicine), Yakutsk

K S Aslanyan

Regional Children's Hospital, Rostov-on-Don

Regional Children's Hospital, Rostov-on-Don

E V Kondakova

Surgut District Hospital, UHMAU-Ugry, Surgut

Surgut District Hospital, UHMAU-Ugry, Surgut

E V Tselousova

Kirov Research Institute of Hematology and Blood Transfusion

Kirov Research Institute of Hematology and Blood Transfusion

N V Myakova

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, MoscowRepublican Children's Hospital, Moscow

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, MoscowRepublican Children's Hospital, Moscow

T V Turobova

Regional Children's Hospital, Arkhangelsk

Regional Children's Hospital, Arkhangelsk

O V Ryskal

Regional Children's Hospital, Perm

Regional Children's Hospital, Perm

N F Chipsanova

Komi Republican Cardiology Dispensary, Syktyvkar

Komi Republican Cardiology Dispensary, Syktyvkar

S R Varfolomeyeva

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

A G Rumyantsev

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

Federal Research and Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow

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Copyright (c) 2020 Rumyantseva Y.V., Karachunsky A.I., Aleinikova O.V., Fechina L.G., Shamardina A.V., Litvinov D.V., Ponomareva N.I., Boichenko E.G., Dudkin S.A., Streneva O.V., Kondratchik K.L., Mansurova E.G., Minkina L.M., Lapotentova E.S., Inyushkina E.V., Yudina N.B., Pavlova G.P., Zhukovskaya E.V., Khlebnikova O.P., Lagoiko S.N., Basharova E.V., Denisov R.E., Zlobina V.D., Banshchikova E.S., Aslanyan K.S., Kondakova E.V., Tselousova E.V., Myakova N.V., Turobova T.V., Ryskal O.V., Chipsanova N.F., Varfolomeyeva S.R., Rumyantsev A.G.

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