Treatment of Relapsed Precursor-B Acute Lymphoblastic Leukemia with Intensive Chemotherapy: POG (Pediatric Oncology Group) Study 9411 (SIMAL 9)

Overview

Journal J Pediatr Hematol Oncol

Specialty Pediatrics

Date 2013 Jul 27

PMID 23887024

Citations 7

Authors

Michael E Kelly

Xiaomin Lu

Meenakshi Devidas

Bruce Camitta

Thomas Abshire

Mark L Bernstein

Amy Billett

Alan Homans

Eric Sandler

George Buchanan

Affiliations

Soon will be listed here.

Abstract

Pediatric patients who experience a bone marrow relapse of precursor-B acute lymphoblastic leukemia are cured <50% of the time. This study was designed to determine if intensification of therapies with known activity in this disease would improve the cure rates for patients with relapsed acute lymphoblastic leukemia. Patients were treated with intensive asparaginase during induction followed by repeated cycles of ifosfamide/etoposide and cytarabine/idarubicin. Patients with well-matched related donors were encouraged to undergo hematopoietic stem cell transplant as consolidation. The results of this study demonstrate no significant difference in disease-free survival in patients who received chemotherapy alone (45%) or chemotherapy followed by allogeneic stem cell transplant (50%). Furthermore, results from this study show no significant difference in event-free survival (39.9%±6.2%) or overall survival (41.6%±6.1%) at 8 years when compared with previous studies using less intensive regimens. Our results suggest that alternative therapies are needed to improve cure rates for pediatric patients with relapsed leukemia.

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