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September 11, 2024LeukemiaOpen Access

Determinants of survival after first relapse of acute lymphoblastic leukemia: a Children’s Oncology Group study

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Authors

SRSusan R. RheingoldChildren's Hospital of PhiladelphiaDBDeepa BhojwaniSupélecLJLingyun JiUniversity of Southern California

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Implication

Cohort study reveals survival determinants after first relapse in childhood acute lymphoblastic leukemia, highlighting recurrence timing and cytogenetics as vital markers for trial design.

Key Points

  • Identify clinical, timing, and cytogenetic prognostic factors influencing overall survival after first relapse in pediatric acute lymphoblastic leukemia.
  • Analyzed 16,115 pediatric patients across 12 Children's Oncology Group frontline acute lymphoblastic leukemia clinical trials conducted from 1996 to 2014, identifying 2,053 (12.7%) who experienced relapse.
  • Evaluated 5-year post-relapse overall survival across disease subtypes (B-ALL, T-ALL, infant ALL), time-to-relapse intervals (early, intermediate, late), relapse sites, and cytogenetic profiles.
  • The 5-year overall survival post-relapse across the cohort was 48.9 ± 1.2%, differing significantly between B-ALL (52.5 ± 1.3%), T-ALL (35.5 ± 3.3%), and infant ALL (21.5 ± 3.9%).
  • Survival increased directly with longer time to relapse: B-ALL survival was 25.8 ± 2.4% for early (<18 months), 49.5 ± 2.2% for intermediate, and 66.4 ± 1.8% for late (≥36 months) relapse, compared to 29.8 ± 3.9%, 33.3 ± 7.6%, and 58.0 ± 9.8% in T-ALL.
  • Cytogenetics significantly impacted post-relapse survival: favorable profiles included ETV6::RUNX1 (74.4 ± 3.1%) and Trisomy 4+10 (70.2 ± 3.6%), whereas hypodiploidy (14.2 ± 6.1%), KMT2A-rearrangement (31.9 ± 7.7%), and TCF3::PBX1 (36.8 ± 6.6%) exhibited dismal outcomes.

Cite This Study

Rheingold et al. (2024) studied this question.

synapsesocial.com/papers/6a86b3c5e925a1267eca00achttps://doi.org/10.1038/s41375-024-02395-4
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