Long-term results of Dana-Farber Cancer Institute ALL Consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000).
Long-term results of Dana-Farber Cancer Institute ALL Consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000).
复制标题
DOI：
10.1038/leu.2009.253
复制
发表时间：
2010-02
期刊：
影响因子：
11.4
通讯作者：
Sallan, S. E.
中科院分区：
文献类型：
--
作者：
Silverman, L. B.;Stevenson, K. E.;O'Brien, J. E.;Asselin, B. L.;Barr, R. D.;Clavell, L.;Cole, P. D.;Kelly, K. M.;Laverdiere, C.;Michon, B.;Schorin, M. A.;Schwartz, C. L.;O'Holleran, E. W.;Neuberg, D. S.;Cohen, H. J.;Sallan, S. E.
Dana-Farber癌症研究所（DFCI）ALL联盟自1981年以来一直在儿童ALL中进行多机构临床试验。治疗主要包括在强化治疗期间连续20-30周的门冬酰胺酶治疗和在继续治疗期间频繁的长春新碱/皮质类固醇脉冲治疗。在1985-2000年期间，1457名0-18岁的儿童接受了四个连续方案的治疗：85-01（1985-7）、87-01（1987-91）、91-01（1991-5）和95-01（1996-2000）。按方案计算的10年无事件生存率（EFS）±标准误分别为77.9 ± 2.8%（85-01）、74.2± 2.3（87-01）、80.8 ± 2.1%（91-01）和80.5 ± 1.8%（95-01）。在1980年代和1990年代接受治疗的患者中，分别约有82%和88%是长期存活者。与20世纪80年代相比，20世纪90年代接受治疗的患者的EFS和总生存率（OS）显著更高（分别为p=0.05和0.01）。在20世纪90年代进行的两项方案中，T-ALL患者的EFS为79-85%，青少年（10-18岁）为75-78%。随机化研究结果显示，右雷佐生可预防高风险患者的急性心脏损伤，而不会对EFS或OS产生不良影响，频繁给药的鞘内化疗是标准风险患者颅部放疗的有效替代品。目前的研究继续关注提高疗效，同时最大限度地减少急性和晚期毒性。
The Dana-Farber Cancer Institute (DFCI) ALL Consortium has been conducting multi-institutional clinical trials in childhood ALL since 1981. The treatment backbone has included 20–30 consecutive weeks of asparaginase during intensification and frequent vincristine/corticosteroid pulses during the continuation phase. Between 1985–2000, 1457 children aged 0–18 years were treated on four consecutive protocols: 85-01 (1985–7), 87-01 (1987–91), 91-01 (1991–5) and 95-01 (1996–2000). The 10-year event-free survival (EFS) ± standard error by protocol was 77.9 ± 2.8% (85-01), 74.2± 2.3 (87-01), 80.8 ± 2.1% (91-01) and 80.5 ± 1.8% (95-01). Approximately 82% of patients treated in the 1980s and 88% treated in the 1990s were long-term survivors. Both EFS and overall survival (OS) rates were significantly higher for patients treated in the 1990s compared with the 1980s (p=0.05 and 0.01, respectively). On the two protocols conducted in the 1990s, EFS was 79–85% for T-ALL patients and 75–78% for adolescents (age 10–18 years). Results of randomized studies revealed that dexrazoxane prevented acute cardiac injury without adversely impacting EFS or OS in high-risk patients and frequently-dosed intrathecal chemotherapy was an effective substitute for cranial radiation in standard-risk patients. Current studies continue to focus on improving efficacy while minimizing acute and late toxicities.
登录
查看更多内容
影响因子：
30.8
作者：
Armstrong, SA;Staunton, JE;Korsmeyer, SJ
通讯作者：
Korsmeyer, SJ
影响因子：
50.3
作者：
Armstrong, SA;Kung, AL;Korsmeyer, SJ
通讯作者：
Korsmeyer, SJ
影响因子：
45.3
作者：
Schwartz, CL;Thompson, EB;Sallan, SE
通讯作者：
Sallan, SE
影响因子：
45.3
作者：
Barry, Elly V.;Vrooman, Lynda M.;Silverman, Lewis B.
通讯作者：
Silverman, Lewis B.
影响因子：
45.3
作者：
Lipshultz, SE;Giantris, AL;Colan, SD
通讯作者：
Colan, SD