Treatment and prognosis of childhood acute lymphoblastic leukemia on protocols ALL-BFM 90, 95 and ALL IC-BFM 2002: a retrospective single-center study from Olomouc, Czech Republic

Abstract

Great progress has been made in the diagnostics and treatment of childhood acute lymphoblastic leukemia (ALL) over the past decades. The vast majority of children are cured, however, there is need for further improvement, especially in specific patient subgroups. Our aim was to retrospectively evaluate disease characteristics and treatment outcomes of children with ALL enrolled in a single center into consecutive treatment protocols (ALL-BFM 90, ALL-BFM 95 and ALL IC-BFM 2002) between years 1990 and 2007 and comprehensively summarize diagnostic and therapeutic advances between protocols. In total, 97 patients aged 0 to 18 years were treated for ALL at University Hospital Olomouc in the Czech Republic and steadily high relapse-free survival (RFS), event-free survival (EFS) and overall survival (OS) were observed during the evaluated time period without significant difference between the protocols (RFS 80-86%, EFS 75-83% and OS 84-92%). In conclusion, our center has demonstrated survival rates comparable to leading international study groups for childhood ALL over a substantial period of time. This has been achieved namely due to advances in diagnostics, excellent collaboration on regional, national and international level, quality assurance and high overall standard of care. The acquired experience has been crucial for current participation in the best performing Berlin-Frankfurt-Münster (BFM)-based international trials for childhood ALL.

Chromosomal aberrations in childhood acute lymphoblastic leukemia: 15-year single center experience

“…Risk group stratification and therapy elements of the treatment Page 3 of 18 protocols have been described in detail elsewhere [15][16][17][18]. The median follow-up period of the study group was 15.6, 12.9 and 8.6 years for ALL-BFM 90, ALL-BFM 95 and ALL IC-BFM 2002, respectively.…”

Long-term Outcome of Children with Acute Lymphoblastic Leukemia Treated with IC-BFM2002 Regimen

“…In a study presented in 2016 from Czechoslovakia, the estimated 5-yr EFS of 24 patients was about 83% [14]. An initial study reported from IC-BFM 2009 by Nath et al in 2019 showed an increase in disease-free survival of 88% [7].…”

Approach to the Adult Acute Lymphoblastic Leukemia Patient

“…First-line chemotherapy for patients under 65 years diagnosed with ALL is the Hoeltzer protocol, which consists of seven steps described in Figure 1 and Table 1 [17,18]. A valid alternative for therapy is the HyperCVAD protocol, which consists of two treatment cycles repeated four times and an additional maintenance chemotherapy cycle (refer to Figure 2 and Table 2) [19,20,21,22,23,24].…”