Intensive Chemotherapy for Childhood Acute Lymphoblastic Leukemia: Results of the Randomized Intercontinental Trial ALL IC-BFM 2002
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2014Metadata
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Stary, Jan
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Intensive Chemotherapy for Childhood Acute Lymphoblastic Leukemia: Results of the Randomized Intercontinental Trial ALL IC-BFM 2002
Author
- Stary, Jan;
- Zimmermann, Martin;
- Campbell, Myriam;
- Castillo, Luis;
- Dibar, Eduardo;
- Donska, Svetlana;
- Gonzalez, Alejandro;
- Izraeli, Shai;
- Janic, Dragana;
- Jazbec, Janez;
- Konja, Josip;
- Kaiserova, Emilia;
- Kowalczyk, Jerzy;
- Kovacs, Gabor;
- Li, Chi Kong;
- Magyarosy, Edina;
- Popa, Alexander;
- Stark, Batia;
- Jabali, Yahia;
- Trka, Jan;
- Hrusak, Ondrej;
- Riehm, Hansjörg;
- Masera, Giuseppe;
- Schrappe, Martin;
Abstract
Purpose
From 2002 to 2007, the International Berlin-Frankfurt-Mu¨ nster Study Group conducted a prospective
randomized clinical trial (ALL IC-BFM 2002) for the management of childhood acute
lymphoblastic leukemia (ALL) in 15 countries on three continents. The aim of this trial was to
explore the impact of differential delayed intensification (DI) on outcome in all risk groups.
Patients and Methods
For this trial, 5,060 eligible patients were divided into three risk groups according to age, WBC,
early treatment response, and unfavorable genetic aberrations. DI was randomized as follows:
standard risk (SR), two 4-week intensive elements (protocol III) versus one 7-week protocol II;
intermediate risk (IR), protocol III 3 versus protocol II 1; high risk (HR), protocol III 3 versus
either protocol II 2 (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP] option), or 3
HR blocks plus single protocol II (Berlin-Frankfurt-Mu¨ nster [BFM] option).
Results
At 5 years, the probabilities of event-free survival and survival were 74% ( 1%) and 82% ( 1%)
for all 5,060 eligible patients, 81% and 90% for the SR (n 1,564), 75% and 83% for the IR (n
2,650), and 55% and 62% for the HR (n 846) groups, respectively. No improvement was
accomplished by more intense and/or prolonged DI.
Conclusion
The ALL IC-BFM 2002 trial is a good example of international collaboration in pediatric oncology.
A wide platform of countries able to run randomized studies in ALL has been established. Although
the alternative DI did not improve outcome compared with standard treatment and the overall
results are worse than those achieved by longer established leukemia groups, the national results
have generally improved.
General note
Artículo de publicación ISI
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J Clin Oncol 32:174-184. © 2013
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