Improved outcome with delayed intensification for children with acute lymphoblastic leukemia and intermediate presenting features: a Childrens Cancer Group phase III trial.

Abstract

Delint improves the EFS rate of children with ALL and intermediate presenting features. Maintenance IT MTX can be safely substituted for CXRT for presymptomatic CNS therapy in children with intermediate-risk characteristics less than 10 years of age.

Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000

“…Protocol II has proven to be one of the most important treatment elements for childhood ALL. [9][10][11]15 In some subgroups, repetition of re-intensification with Protocol II has been effective in preventing even more relapses. 60,61 (3) Intensive consolidation (Protocol E in ALL-BFM 86, modified HR blocks in ALL-BFM 95) and delayed re-intensification (Protocol II) appear to be essential in particular in prednisone-resistant HR patients (Figures 3c and d).…”

“…[5][6][7] The concept of delayed intensification was probably one of the most significant contributions to all antileukemic regimens for ALL worldwide. [8][9][10] Vincristine/prednisone pulses in maintenance therapy had shown no significant benefit in SR patients in ALL-BFM 79 (randomized study) and were no longer used. 11 Results of the subsequent trials between 1981 and 2000 are presented here.…”

The interval between courses of high-dose chemotherapy with stem cell rescue: therapeutic hypotheses

“…The delayed intensification was not high-dose in the above context, but rather emphasized polychemotherapy including vincristine, doxorubicin, asparaginase, dexamethasone, IT methotrexate, cyclophosphamide and ara-C and thioguanine. 21,22 …”

“…21 Because of provocative phase II results, developed by the Berlin, Frankfurt, Muenster, (BFM Group). 22 CCG (Children's Cancer Group) designed a complex study of pediatric ALL, the relevant part of which follows. 22 After remission induction and consolidation, the patients were randomized to receive intensification chemotherapy either immediately or after an interval of 12 weeks.…”

“…22 CCG (Children's Cancer Group) designed a complex study of pediatric ALL, the relevant part of which follows. 22 After remission induction and consolidation, the patients were randomized to receive intensification chemotherapy either immediately or after an interval of 12 weeks. This study involved only the 50% of patients with intermediate risk stages of ALL.…”