Treatment abandonment in childhood acute lymphoblastic leukaemia in China: a retrospective cohort study of the Chinese Children’s Cancer Group

Cai, Jiaoyang; Yu, Jie; Zhu, Xiaofan; Hu, Shaoyan; Zhu, Yiping; Jiang, Hua; Li, Chunfu; Fang, Yongjun; Liang, Chaozhao; Ju, Xiuli; Tian, Xin; Zhai, Xiaowen; Hao, Ji‐Long; Hu, Qun; Wang, Ningling; Jiang, Hui; Sun, Lirong; Li, Chi Kong; Pan, Kaili; Yang, Minghua; Shen, Shuhong; Cheng, Cheng; Ribeiro, Raul C.; Pui, Ching‐Hon; Tang, Jingyan

doi:10.1136/archdischild-2018-316181

Cited by 50 publications

(72 citation statements)

References 25 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The chemotherapy protocol of CCCG-ALL-2015 study was based on St Jude Children's Research Hospital Total XV study with modification. 1 Patients were stratified into low risk (LR), intermediate risk (IR), and high risk (HR) based on clinical, biological, and treatment responses. The study protocol did not include supportive care guidance on infection control or management.…”

Section: Methodsmentioning

confidence: 99%

Septicemia after chemotherapy for childhood acute lymphoblastic leukemia in China: A multicenter study CCCG‐ALL‐2015

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Septicemia is an important cause of treatment‐related mortality and treatment failure in pediatric acute lymphoblastic leukemia (ALL) in developing countries. A multicenter CCCG‐ALL‐2015 study was conducted in China and factors associated with septicemia and mortality were studied. Methods Patients participated in CCCG‐ALL‐2015 study from January 2015 to December 2017 were included. Patients with documented septicemia were identified from the Data Center and additional data were collected. Results A total of 4080 patients were recruited in the study and 527 patients with septicemia were identified (12.9%, 95% CI 11.9%‐13.9%). The intermediate risk (IR)/high risk (HR) group had significantly higher incidence of septicemia as compared with low risk (LR) group, 17.1% vs 9.1% (OR 2.07, 95% CI 1.71‐2.49, P < .001). Induction phase was the period with majority of septicemia episodes happened, 66.8% in LR and 56.1% in IR/HR groups. Gram‐positive bacteria accounted for 54.1%, gram‐negative bacteria 44.5%, and fungus 1.4% of positive cultures. Multidrug‐resistant organisms were detected in 20.5% of all organisms. The mortality rate after septicemia was 3.4% (95% CI 1.9%‐4.9%). Multiple logistic regression identified female gender, comorbid complications, and fungal infection as risk factors associated with mortality. Gram‐negative septicemia was associated with higher mortality, 4.9% vs 1.4% (OR 0.28, 95% CI 0.09‐0.88, P = .02). There was marked variation in the incidence of septicemia among the 18 centers, from 4.8% to 29.1%. Conclusion Overall the incidence and pattern of septicemia in this multicenter study in China was similar to the reports of western countries. The septicemia‐related mortality rate was low. There was marked variation in the incidence of septicemia among the centers.

show abstract

Section: Methodsmentioning

confidence: 99%

Septicemia after chemotherapy for childhood acute lymphoblastic leukemia in China: A multicenter study CCCG‐ALL‐2015

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Results of the fusion gene analysis by fluorescence in situ hybridization (FISH) were negative. Therefore, the diagnosis of B-ALL was confirmed, CR (defined as <5% lymphoblasts in bone marrow aspirate) was achieved through the standard risk protocol of CCCG-ALL -2015 (upfront window therapy with dexamethasone for 4 days; subsequently, remission induction with prednisone, vincristine, daunorubicin and PEG-asparaginase from day 5 to day 28, and cyclophosphamide, cytarabine and mercaptopurine from day 29 to day 35), 8 followed by consolidated combination chemotherapy in next 10 months. However, fever and bleeding occurred.…”

Section: Case Presentationmentioning

confidence: 99%

<p>Sequential Infusion of Anti-CD22 and Anti-CD19 Chimeric Antigen Receptor T Cells for a Pediatric Ph-Like B-ALL Patient That Relapsed After CART-Cell and Haplo-HSCT Therapy: A Case Report and Review of Literature</p>

Hua¹,

Qian²,

Wu³

et al. 2020

OTT

View full text Add to dashboard Cite

Pediatric Philadelphia chromosome-like (Ph-like) acute B-lymphoblastic leukemia (B-ALL), a high-risk subset of BALL characterized by a gene expression profile similar to that of Ph-positive ALL, has extremely poor outcome after a relapse following autologous chimeric antigen receptor (CAR)-T and haploidentical (haplo) hematopoietic stem cell transplantation(HSCT)therapy. with very limited treatment options. Donor-derived CAR T-cell therapy, the most vital advanced anticancer technology, may be a promising salvage strategy for patients with Ph-like BALL. Here, we presented a relapsed and refractory case of a child with Ph-like BALL after autologous anti-CD19 CAR T-cell therapy followed by haplo-HSCT. She successfully achieved the fourth complete remission (CR4) and maintained CR for five months after the sequential infusion of donor-derived anti-CD22 and anti-CD19 CAR T cells, with mild CRS side effects and no obvious graft-versus-host disease. A donorderived anti-CD22 and-CD19 CAR T-cell therapy combined with a sequential infusion strategy may provide a promising alternative treatment strategy as effective and safe salvage therapy for children with recurrent and refractory Ph-like BALL after autologous CD19directed CAR T-cell therapy followed by haplo-HSCT.

show abstract

“…However, the proportion of patients who did not complete treatment decreased to 20% at a single institution and to only 3% in the latest CCCG-led ALL study. 41,42 This improvement is attributed to the enhanced national health insurance program, which finances the cost for pediatric leukemia treatment, and to better informed patient families. Nevertheless, treatment abandonment for children with CNS tumors is not fully acknowledged and should be addressed.…”

Section: Abandonment Financing Treatment and Loss To Follow-upmentioning

confidence: 99%

Challenges and opportunities for managing pediatric central nervous system tumors in China

Liu

Moreira

Sun

et al. 2020

Pediatric Investigation

View full text Add to dashboard Cite

Central nervous system (CNS) tumors represent the most deadly cancer in pediatric age group. In China, thousands of children are diagnosed with CNS tumors every year. Despite the improving socioeconomic status and availability of medical expertise within the country, unique challenges remain for the delivery of pediatric neuro-oncology service. In this review, we discuss the existing hurdles for improving the outcome of children with CNS tumors in China. Need for precise disease burden estimation, lack of intra-and interhospital collaborative networks, high probability of treatment abandonment, along with financial toxicities from treatment represent the key challenges that Chinese healthcare providers encounter. The tremendous opportunities for advancing the status of pediatric neuro-oncology care in and beyond the country are explored.

show abstract

Treatment abandonment in childhood acute lymphoblastic leukaemia in China: a retrospective cohort study of the Chinese Children’s Cancer Group

Cited by 50 publications

References 25 publications

Septicemia after chemotherapy for childhood acute lymphoblastic leukemia in China: A multicenter study CCCG‐ALL‐2015

Septicemia after chemotherapy for childhood acute lymphoblastic leukemia in China: A multicenter study CCCG‐ALL‐2015

<p>Sequential Infusion of Anti-CD22 and Anti-CD19 Chimeric Antigen Receptor T Cells for a Pediatric Ph-Like B-ALL Patient That Relapsed After CART-Cell and Haplo-HSCT Therapy: A Case Report and Review of Literature</p>

Challenges and opportunities for managing pediatric central nervous system tumors in China

Contact Info

Product

Resources

About