Risk- and response-based classification of childhood B-precursor acute lymphoblastic leukemia: a combined analysis of prognostic markers from the Pediatric Oncology Group (POG) and Children's Cancer Group (CCG)
Risk- and response-based classification of childhood B-precursor acute lymphoblastic leukemia: a combined analysis of prognostic markers from the Pediatric Oncology Group (POG) and Children's Cancer Group (CCG)
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DOI：
10.1182/blood-2006-01-024729
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发表时间：
2007-02-01
期刊：
影响因子：
20.3
通讯作者：
Camitta, Bruce M.
中科院分区：
文献类型：
--
作者：
Schultz, Kirk R.;Pullen, D. Jeanette;Camitta, Bruce M.
2000年，儿童癌症小组（CCG）和儿童肿瘤小组（POG）联合成立了儿童肿瘤小组（COG）。这一合并允许对急性淋巴细胞白血病（ALL）的临床、生物学和早期反应数据进行分析，以预测无事件生存（EFS），从而开发出一种新的分类系统和治疗算法。在CCG（1988年12月至1995年8月，n = 4986）和POG（1986年1月至1999年11月，n = 6793）连续登记的11779例新诊断为b前体ALL的儿童（年龄，1至21.99岁）中，我们回顾性分析了6238例患者（CCG, 1182； POG, 5056），并获得了有益的细胞遗传学数据。四个风险组被定义为非常高风险（VHR； 5年EFS， 45%或以下），低风险（5年EFS，至少85%），以及标准和高风险（那些留在各自国家癌症研究所[NCl]风险组中的人）。VHR标准包括极端低外交（少于44条染色体），t（9;22）和/或BCR/ ABL，诱导失败。低风险患者为NCI标准风险患者，有t(12;21) （TEL/AML1）或同时存在4、10和17号染色体三体。即使存在治疗差异，CCG和POG分析之间也有很高的一致性。COG风险分类方案用于将b前体ALL分为低（27%）、标准（32%）、高（37%）和极高（4%）风险组，基于年龄、白细胞（WBC）计数、细胞遗传学、第14天骨髓反应和终末诱导最小残留病（MRD），通过流式细胞术进行COG试验。
The Children's Cancer Group (CCG) and the Pediatric Oncology Group (POG) joined to form the Children's Oncology Group (COG) in 2000. This merger allowed analysis of clinical, biologic, and early response data predictive of event-free survival (EFS) in acute lymphoblastic leukemia (ALL) to develop a new classification system and treatment algorithm. From 11 779 children (age, 1 to 21.99 years) with newly diagnosed B-precursor ALL consecutively enrolled by the CCG (December 1988 to August 1995, n = 4986) and POG (January 1986 to November 1999, n = 6793), we retrospectively analyzed 6238 patients (CCG, 1182; POG, 5056) with informative cytogenetic data. Four risk groups were defined as very high risk (VHR; 5-year EFS, 45% or below), lower risk (5-year EFS, at least 85%), and standard and high risk (those remaining in the respective National Cancer Institute [NCl] risk groups). VHR criteria included extreme hypodiploicly (fewer than 44 chromosomes), t(9;22) and/or BCR/ ABL, and induction failure. Lower-risk patients were NCI standard risk with either t(12;21) (TEL/AML1) or simultaneous trisomies of chromosomes 4, 10, and 17. Even with treatment differences, there was high concordance between the CCG and POG analyses. The COG risk classification scheme is being used for division of B-precursor ALL into lower- (27%), standard- (32%), high-(37%), and very- high- (4%) risk groups based on age, white blood cell (WBC) count, cytogenetics, day-14 marrow response, and end induction minimal residual disease (MRD) by flow cytometry in COG trials.