Erfahrungen mit modifizierten BFM-Protokollen bei der Behandlung von Kindern mit akuten lymphoblastischen Leukämien (ALL) in den ostdeutschen Ländern von 1981 bis 1991

Abstract

Between September and August 1991 818 previously untreated children and adolescents up to 18 years of age with acute lymphoblastic leukemia were entered into two modified BFM-protocols. Patients with B-ALL were excluded. From 1981 to 1987 524 patients were entered into the randomized multicenter study ALL VII/81 (modified ALL-BFM 81 protocol). Patients were divided into three risk groups standard (SR), medium (MR), high risk (HR) using the BFM risk factor. In a connecting study from 1988 to 1991 294 patients were registered on the stratified and randomized multicentric trial ALL VIII/87 (modified ALL-BFM 86 study). The main modification in study ALL VII/81 concerned the duration of treatment. Patients were randomized into two groups. The first group received as a late reinduction protocol III and then therapy was stopped. The second group received 6-MP and MTX for another six months. The other whole treatment strategy of ALL-BFM 81 was adopted. In protocol ALL VIII/87 the only modification was the reduction of the MTX dosage from 5 g/m2 to 1 g/m2 with an infusion time of 24 hours (leucovorin rescue 15 mg/m2 after 48 and 54 hours). The probability of the event-free-survival (EFS) for study ALL VII/81 was 59%. CNS events were significantly more frequent in standard risk patients with intermediate dose MTX (4 x 0.5 g/m2) compared with the irradiation group (18 Gy). The EFS for SR patients amounts to 61%, for MR patients to 59% and for HR patients to 36%. There was no significant difference of EFS for the two groups with different duration of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Survival in Children Below the Age of 15 Years With Leukemia: Temporal Patterns in Eastern and Western Germany Since German Reunification

“…Treatment of childhood leukemia has been highly standardized over the past decades. In the GDR, treatment was performed according to protocols only slightly modified from those in Western Germany, with all drugs available (in principle) 15 . The standardized treatment protocols from Western Germany were implemented in all of Germany immediately after reunification.…”

“…In the GDR, treatment was performed according to protocols only slightly modified from those in Western Germany, with all drugs available (in principle). 15 The standardized treatment protocols from Western Germany were implemented in all of Germany immediately after reunification. The lower population density in the former GDR combined with lacking information technology and poorer infrastructure and socioeconomic conditions may have played an important role in healthcare provision.…”

Ergebnisse und Erfahrungen mit einem modifizierten BFM-Protokoll zur Rezidivbehandlung von Kindern mit akuten lymphoblastischen Leukämien(ALL) in den ostdeutschen Ländern

“…Alle Patienten erhielten 1 glm 2 MTX über 36 Stunden mit nachfolgender zweimaliger Leukovorin-Rescue nach 48 und 54 Stunden (15 mglm 2 ). Die Initialbehandlung wurde bei allen Patienten mit den modifizierten BFM-Protokollen ALL VII/81 (ALL-BFM 81) und ALL VIII/87 (ALL-BFM 86) durchgeführt (19,25). Diese Therapie besteht aus einer Induktionstherapie mit Prednisolon, Vincristin, Daunoblastin und Asparaginase gefolgt von einer Konsolidierung mit Cytosinarabi.…”