Chemotherapy in 998 unselected childhood acute lymphoblastic leukemia patients. Results and conclusions of the multicenter trial ALL-BFM 86
Why the study?
Does risk-stratified chemotherapy based on early prednisone response improve event-free survival in unselected childhood acute lymphoblastic leukemia patients?
Population
998 unselected childhood acute lymphoblastic leukemia (ALL) patients
Comparison
Risk-stratified chemotherapy based on day 8… vs Within Risk Group: randomized to receive or not…
Design
RCT, In branch RG, patients were randomized to receive or not to receive late…
Follow-up
median 5.0 (range 3.4 to 6.9) years
Authors
Discussion
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Implication
Risk-stratified reinduction chemotherapy yields durable EFS in most childhood ALL; reinforces response-adapted intensification as standard in unselected patients.
Structured PICO
Does risk-stratified chemotherapy based on early prednisone response improve event-free survival in unselected childhood acute lymphoblastic leukemia patients?
P
Population
998 unselected childhood acute lymphoblastic leukemia (ALL) patients
I
Intervention
Risk-stratified chemotherapy based on day 8 blood blast response to initial prednisone treatment, including induction, consolidation, and intensive reinduction
C
Comparator
Within Risk Group: randomized to receive or not receive late intensification. Within Standard Risk Group: sequential comparison of no reinduction vs reinduction therapy.
O
Outcome
Event-free survival at 6 yearshard clinical
Risk-stratified chemotherapy incorporating intensive reinduction therapy offers approximately 75% of unselected childhood ALL patients the chance for long-term event-free survival.
Limitations
- Only 23% of the eligible patients in the Risk Group were randomized for late intensification
Cite This Study
Reiter et al. (1994) studied this question.