International Collaboration on Childhood Leukemia

Pui, Ching‐Hon; Ribeiro, Raul C.

doi:10.1007/bf02983810

Cited by 47 publications

(40 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hunger et al (2009) proposed for a systematic and graduated approach to ALL diagnosis, risk classification, and treatment in LICs [24]. Twinning approach to pediatric ALL treatment has been in place in Central and South America, Northwest Africa, and Southeast Asia for as long as 15 years [25][26][27]. These programs have reduced the rates of abandonment of treatment, relapse, and death due to treatment toxicities.…”

Section: Discussionmentioning

confidence: 99%

Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

et al. 2012

View full text Add to dashboard Cite

With modern risk-adapted therapy, over 80% of children with acute lymphoblastic leukemia (ALL) in highincome countries (HICs) are cured. In countries with limited resources, however, therapy results for pediatric ALL are still not encouraging. We describe our experience in treating children with ALL using a risk-adapted protocol at a tertiary referral center in Lebanon. From May 2002 to August 2009, 111 consecutive patients 1-21 years of age with newly diagnosed ALL received the CCCL ALL protocol which was based on the St. Jude Children's Research Hospital Total XV Study. The median age at diagnosis was 5 years 5 months. The male to female ratio was 1.5. Forty-six patients received the intermediate-/high-risk arm and 65 received the low-risk arm. Only one patient (0.9%) died during induction therapy. Relapse occurred in 8 (7.2%) patients. Eight (7.2%) patients died, 4 of whom were in remission. The median follow-up of the patients was 38 months. The 5-year overall survival and event-free survival were and 88.5% (95% CI: 77.1-94.4) and 78.7% (95% CI: 69.8-88.4), respectively. Our results are comparable to those in HICs in spite of the limited resources and the relatively low socioeconomic status of the Lebanese population. Children treated on this protocol experienced significant toxicity necessitating expert supportive care, but benefited from improved cure rates and prolonged survival. Am. J. Hematol. 87:678-683, 2012. V

show abstract

Section: Discussionmentioning

confidence: 99%

Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Although developing countries often follow treatment protocols from developed countries, limited resources can prevent delivery of optimal care, resulting in poorer survival in ALL, 10% to 60% versus >80%. [38][39][40] This disparity may become more significant as developed nations use more sophisticated studies for early identification of highrisk patients, eg, quantitative polymerase chain reaction (PCR) and flow cytometry-based MRD analysis. Although we advocate for the global use of MRD technology, in some circumstances these assays may not be technologically and/or economically feasible.…”

Section: Immune Status In Acute Leukemiamentioning

confidence: 99%

Absolute lymphocyte count is a novel prognostic indicator in ALL and AML

Angulo¹,

Yuen²,

Palla³

et al. 2007

Cancer

112

View full text Add to dashboard Cite

BACKGROUND.Leukemia is the leading cause of disease‐related death in children, despite significant improvement in survival and modern risk stratification. The prognostic significance of absolute lymphocyte counts (ALC) was evaluated in young patients with acute myeloblastic leukemia (AML) and acute lymphoblastic leukemia (ALL).METHODS.In all, 171 consecutive de novo cases of AML and ALL, age ≤21 years, were analyzed. Age, initial white blood cell count, cytogenetics, and bone marrow response were compared with lymphocyte, neutrophil, and platelet counts at weekly intervals during induction chemotherapy.RESULTS.ALC is a significant independent predictor of relapse and survival. For example, in patients with AML an ALC on Day 28 of induction (ALC‐28) <350 cells/μL predicts very poor survival, with a 5‐year relapse‐free survival (RFS) of only 10% (hazard ratio [HR] 3.7, P = .003). In contrast, an ALC‐15 >350 cells/μL carries an excellent prognosis, with a 5‐year overall survival (OS) of 85% (HR 0.2, P = .012). Similarly in ALL, an ALC‐15 <350 cells/μL predicts poor survival, with a 6‐year RFS of 43% (HR 4.5, P = .002), whereas an ALC‐15 >350 cells/μL predicts excellent outcome, with a 6‐year OS of 87% (HR 0.2, P = .018). Importantly, ALC remains a strong predictor in multivariate analysis with known prognostic factors.CONCLUSIONS.ALC is a simple, statistically powerful measurement for patients with de novo AML and ALL. The results, when combined with previous studies, demonstrate that ALC is a powerful new prognostic factor for a range of malignancies. These findings suggest a need for further exploration of postchemotherapy immune status and immune‐modulating cancer therapies. Cancer 2008. © 2007 American Cancer Society.

show abstract

“…Establishment of an international acute lymphoblastic leukemia (ALL) working group in 1995 by members of the Associazione Italiana di Ematologia ed Oncologia Pediatria (AIEOP), the Berlin-Frankfurt-Mü nster (BFM) Study Group, the Children's Oncology Group (COG), and St Jude Children's Research Hospital, 1 with the subsequent addition of other large cooperative study groups, 2,3 has led to substantial progress in international collaboration in leukemia research. The intent of the group was to define essential factors for the diagnosis and therapy of ALL and to put forward common strategies for the prevention and reduction of treatment toxicity.…”

Section: Introductionmentioning

confidence: 99%