A study of “total therapy” of acute lymphocyticleukemia in children

George, Phillip; Hernandez, Kathleen; Hustu, Omar; Borella, Luis; Holton, Charlene P.; Pinkel, Donald

doi:10.1016/s0022-3476(68)80217-3

Cited by 107 publications

(29 citation statements)

References 13 publications

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“…In Korea, the age-standardized incidence rate of ALL is approximately 28 patients per million in the 0–14 year old age group1). Whereas 50 years ago the survival for pediatric ALL was 10%–20%2), currently long-term overall survival (OS) rates are 80%–90%345). In Korea also, we reported a 10-year event-free survival (EFS) of 78.5% and OS of 81.9% for a large number of patients treated on CMCP-ALLL2005 and -ALL2008 regimens6).…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors and treatment of pediatric acute lymphoblastic leukemia

Lee

Cho

2017

Korean J Pediatr

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The event-free survival (EFS) for pediatric acute lymphoblastic leukemia (ALL) has shown remarkable improvement in the past several decades. In Korea also, a recent study showed 10-year EFS of 78.5%. Much of the improved outcome for pediatric ALL stems from the accurate identification of prognostic factors, the designation of risk group based on these factors, and treatment of appropriate duration and intensity according to risk group, done within the setting of cooperative clinical trials. The schema of first-line therapy for ALL remains mostly unchanged, although many groups have now reported on the elimination of cranial irradiation in all patients with low rates of central nervous system relapse. Specific high risk subgroups, such as Philadelphia chromosome-positive (Ph+) ALL and infant ALL continue to have significantly lower survival than other ALL patients. The introduction of tyrosine kinase inhibitors into therapy has led to enhanced outcome for Ph+ ALL patients. Infant ALL patients, particularly those with MLL rearrangements, continue to have poor outcome, despite treatment intensification including allogeneic hematopoietic cell transplantation. Relapsed ALL is a leading cause of mortality in pediatric cancer. Recent advances in immunotherapy targeting the CD19 of the ALL blast have shown remarkable efficacy in some of these relapsed and refractory patients. With improved survival, much of the current focus is on decreasing the long-term toxicities of treatment.

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Section: Introductionmentioning

confidence: 99%

Prognostic factors and treatment of pediatric acute lymphoblastic leukemia

Lee

Cho

2017

Korean J Pediatr

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“…However, the combination of prednisone and vincristine was found to be capable of inducing a complete remission in nearly all children with previously untreated ALL, and this method of remission induction formed a foundation for ''total therapy" studies with the ultimate goal being the cure of childhood ALL [1], Combination chemotherapy in maximally tolerated dosages for two to three years was employed as maintainance therapy, and the results of these early studies yielded a 17 % five-year leukemia-free survival [2], The administration of periodic courses of prednisone plus vincristine during remis sion was shown to prolong the duration of complete remission in patients maintained on 6-mercaptopurine (6-MP) alone [3] and the reinforcement pulses were later used in total therapy studies [4], The addition of prophylactic central ner vous system therapy with cither craniospinal irradiation or cranial irradiation plus intrathecal methotrexate has greatly reduced the incidence of meningeal leukemia and improved the duration of complete remission and survival, and these present studies in childhood ALL have achieved a 40% fiveyear leukemia-free survival [5]. The relative ease of induction of complete remission and dramatic prolongation of survival in childhood ALL has not been paralleled by similar results in adults with ALL [6,7].…”

Section: Introductionmentioning

confidence: 99%

Remission Induction with Daunomycin, Vincristine, and Prednisone in Adult Acute Lymphocytic Leukemia

Einhorn¹,

Bond²

1977

Oncology

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Prednisone plus vincristine plus daunomycin induced complete remission in nine adults with acute lymphocytic leukemia. The median duration of complete remission will be between 14 and months, with three patients remaining in hematological remission at 10+, 11+, and 18+ months; The median survival will be between and 23 months, with all patients surviving at least one year. This remission induction regimen produced rapid complete remission in adult acute lymphocytic leukemia (ALL) with minimal toxicity, and could be administered predominantly on an outpatient basis.

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“…Today, the majority of children with acute lymphocytic leukemia are cured by the aggressive use of combination chemotherapy programs (61,62). In the early 1960s, advanced Hodgkin's disease was also uniformly fatal and treated with single alkylating agents.…”

Section: The 1960s-the Concept Of Curementioning

confidence: 99%