St. Jude Total Therapy studies from I to XVII for childhood acute lymphoblastic leukemia: a brief review

Abstract

The therapy design of childhood acute lymphoblastic leukemia (ALL) has evolved over the past 60 years. The St. Jude Children’s Research Hospital has developed 17 treatment protocols from 1962 to 2017, aiming to have the most effective and least toxic treatment form. This review summarizes each protocol’s objectives, inclusion criteria, treatment phases, pharmacological agents, irradiation therapy, response criteria, risk stratification, type of relapse, and overall survival. The enhancement and successful application of preventive therapy for ALL and following a risk-stratified approach have progressively improved the cure rate of childhood ALL, with relatively few adverse sequelae. Moreover, St. Jude’s scientific theme serves as a reminder of the principal factor of research directed to a catastrophic disease such as ALL.

Effect of chemotherapy (with and without radiotherapy) on the intelligence of children and adolescents treated for acute lymphoblastic leukemia; a meta‐analysis

“…In this meta‐analysis, weighted mean IQ in the CTRT group was lower than in the CT‐only group, with means of both groups falling outside of the confidence interval of the other group. In line with the hypothesis that contemporaneous CTRT regimens are less neurotoxic 72–74 …”

“…In line with the hypothesis that contemporaneous CTRT regimens are less neurotoxic. [72][73][74] When we restricted the meta-analysis to patients treated from 2000 onwards, mean IQ in the CTRT group was higher than in the entire CTRT group. The sub-analysis on treatments since 2000 mostly focused on CT-only studies (n = 16), rather than CTRT studies (n = 3), as this was the main trend in treatment adaptation.…”

Therapy of childhood acute lymphoblastic leukemia in resource-poor geospaces

“…Second, we lacked cytogenetic and mutation analyses for some children. Third, substantial numbers of children were lost to follow-up, a common problem in resourcepoor geospaces (17,18). Fourth, the value of currency has changed in our country during the study.…”

The frequency of NUDT15 rs116855232 and its impact on mercaptopurine-induced toxicity in Syrian children with acute lymphoblastic leukemia

“…The intermediate-risk patients were aged more than or equal to 10 years with T cell or more than 50 × 10 9 /L or B cell with CNS or testicular leukemia, less than 45 chromosomes (hypodiploid), MLL rearrangement, or E2A-PBX1 fusion or patient with bone marrow blasts ≥ 5 at days 19 or 26 or MRD < 1 ≥ 0.01% at the end of induction and patients that did not meet low- or high-risk criteria. The high-risk group includes those with t(9;22) BCR-ABL fusion or patients with induction failure (bone marrow blasts more or equal 5%) or MRD ≥1% at the end of induction or MRD ≥ 0.1% at week 7 ( 19 ).…”