Intensive BFM chemotherapy for childhood ALL

Interim analysis of the AIEOP-ALL 91 study

Valentino Conter, Maurizio Aricò, Maria Grazia Valsecchi, Carmelo Rizzari, Annamaria Testi, Roberto Miniero, Maria Teresa Di Tullio, Luca Lo Nigro, Andrea Pession, Roberto Rondelli, Chiara Messina, Nicola Santoro, Pier Giorgio Mori, Giulio De Rossi, Paolo Tamaro, Daniela Silvestri, Andrea Biondi, Giuseppe Basso, Giuseppe Masera

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Abstract

Background and Objective. Since 1988 the AIEOP has used BFM-based chemotherapy for childhood ALL. Current organization and results and role of cranial irradiation in the AIEOP-ALL 91 study are reported. Design and Methods. From 1991 to 1995, 1194 children ( 1 year, non-T-ALL, BFM risk factor (RF) 2, a modified protocol II, and continuation therapy with triple intrathecal chemotherapy (TIT); IR patients received protocol Ib, HD-MTX 5 g/m2, protocol II and continuation therapy with TIT; HR patients received 9 polychemotherapy blocks, cranial irradiation and continuation therapy. Duration of treatment was 24 months. A randomized study was conducted to evaluate the impact of high-dose asparaginase in non high risk patients: the results of this study cannot be disclosed yet. Results. One thousand one hundred and fifty-two (96.5%) patients achieved CR. Overall EFS (SE) at 5-years was 71.0% (1.4), with a survival of 80.3% (1.3). Relapse occurred in 262 children (21.9%), either in the marrow (n=192 isolated and 32 with other sites, 18.7%). In the CNS (n=18, 1.5%), or elsewhere (n=20, 1.7%). 5-year EFS (SE) was 83.3% (2.4) in SR, 74.7% (1.8) in IR, and 39.7% (3.5) in HR groups, respectively. Interpretation and Conclusions. Overall cure rate was higher than in the previous AIEOP-ALL 88 study. Treatment intensification with polychemotherapy blocks did not improve results in HR. Cranial irradiation can be safely omitted in over 80% of children treated with BFM based chemotherapy.

Original languageEnglish
Pages (from-to)791-799
Number of pages9
JournalHaematologica
Volume83
Issue number9
Publication statusPublished - Sep 1998

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Cranial Irradiation
Drug Therapy
Combination Drug Therapy
Therapeutics
Asparaginase
Bone Marrow
Recurrence
Survival

Keywords

  • Acute lymphoblastic leukemia
  • BFM chemotherapy
  • Children
  • Cranial irradiation
  • Prognostic factors

ASJC Scopus subject areas

  • Hematology

Cite this

Conter, V., Aricò, M., Valsecchi, M. G., Rizzari, C., Testi, A., Miniero, R., ... Masera, G. (1998). Intensive BFM chemotherapy for childhood ALL: Interim analysis of the AIEOP-ALL 91 study. Haematologica, 83(9), 791-799.

Intensive BFM chemotherapy for childhood ALL : Interim analysis of the AIEOP-ALL 91 study. / Conter, Valentino; Aricò, Maurizio; Valsecchi, Maria Grazia; Rizzari, Carmelo; Testi, Annamaria; Miniero, Roberto; Di Tullio, Maria Teresa; Lo Nigro, Luca; Pession, Andrea; Rondelli, Roberto; Messina, Chiara; Santoro, Nicola; Mori, Pier Giorgio; De Rossi, Giulio; Tamaro, Paolo; Silvestri, Daniela; Biondi, Andrea; Basso, Giuseppe; Masera, Giuseppe.

In: Haematologica, Vol. 83, No. 9, 09.1998, p. 791-799.

Research output: Contribution to journalArticle

Conter, V, Aricò, M, Valsecchi, MG, Rizzari, C, Testi, A, Miniero, R, Di Tullio, MT, Lo Nigro, L, Pession, A, Rondelli, R, Messina, C, Santoro, N, Mori, PG, De Rossi, G, Tamaro, P, Silvestri, D, Biondi, A, Basso, G & Masera, G 1998, 'Intensive BFM chemotherapy for childhood ALL: Interim analysis of the AIEOP-ALL 91 study', Haematologica, vol. 83, no. 9, pp. 791-799.
Conter V, Aricò M, Valsecchi MG, Rizzari C, Testi A, Miniero R et al. Intensive BFM chemotherapy for childhood ALL: Interim analysis of the AIEOP-ALL 91 study. Haematologica. 1998 Sep;83(9):791-799.
Conter, Valentino ; Aricò, Maurizio ; Valsecchi, Maria Grazia ; Rizzari, Carmelo ; Testi, Annamaria ; Miniero, Roberto ; Di Tullio, Maria Teresa ; Lo Nigro, Luca ; Pession, Andrea ; Rondelli, Roberto ; Messina, Chiara ; Santoro, Nicola ; Mori, Pier Giorgio ; De Rossi, Giulio ; Tamaro, Paolo ; Silvestri, Daniela ; Biondi, Andrea ; Basso, Giuseppe ; Masera, Giuseppe. / Intensive BFM chemotherapy for childhood ALL : Interim analysis of the AIEOP-ALL 91 study. In: Haematologica. 1998 ; Vol. 83, No. 9. pp. 791-799.
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abstract = "Background and Objective. Since 1988 the AIEOP has used BFM-based chemotherapy for childhood ALL. Current organization and results and role of cranial irradiation in the AIEOP-ALL 91 study are reported. Design and Methods. From 1991 to 1995, 1194 children ( 1 year, non-T-ALL, BFM risk factor (RF) 2, a modified protocol II, and continuation therapy with triple intrathecal chemotherapy (TIT); IR patients received protocol Ib, HD-MTX 5 g/m2, protocol II and continuation therapy with TIT; HR patients received 9 polychemotherapy blocks, cranial irradiation and continuation therapy. Duration of treatment was 24 months. A randomized study was conducted to evaluate the impact of high-dose asparaginase in non high risk patients: the results of this study cannot be disclosed yet. Results. One thousand one hundred and fifty-two (96.5{\%}) patients achieved CR. Overall EFS (SE) at 5-years was 71.0{\%} (1.4), with a survival of 80.3{\%} (1.3). Relapse occurred in 262 children (21.9{\%}), either in the marrow (n=192 isolated and 32 with other sites, 18.7{\%}). In the CNS (n=18, 1.5{\%}), or elsewhere (n=20, 1.7{\%}). 5-year EFS (SE) was 83.3{\%} (2.4) in SR, 74.7{\%} (1.8) in IR, and 39.7{\%} (3.5) in HR groups, respectively. Interpretation and Conclusions. Overall cure rate was higher than in the previous AIEOP-ALL 88 study. Treatment intensification with polychemotherapy blocks did not improve results in HR. Cranial irradiation can be safely omitted in over 80{\%} of children treated with BFM based chemotherapy.",
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T1 - Intensive BFM chemotherapy for childhood ALL

T2 - Interim analysis of the AIEOP-ALL 91 study

AU - Conter, Valentino

AU - Aricò, Maurizio

AU - Valsecchi, Maria Grazia

AU - Rizzari, Carmelo

AU - Testi, Annamaria

AU - Miniero, Roberto

AU - Di Tullio, Maria Teresa

AU - Lo Nigro, Luca

AU - Pession, Andrea

AU - Rondelli, Roberto

AU - Messina, Chiara

AU - Santoro, Nicola

AU - Mori, Pier Giorgio

AU - De Rossi, Giulio

AU - Tamaro, Paolo

AU - Silvestri, Daniela

AU - Biondi, Andrea

AU - Basso, Giuseppe

AU - Masera, Giuseppe

PY - 1998/9

Y1 - 1998/9

N2 - Background and Objective. Since 1988 the AIEOP has used BFM-based chemotherapy for childhood ALL. Current organization and results and role of cranial irradiation in the AIEOP-ALL 91 study are reported. Design and Methods. From 1991 to 1995, 1194 children ( 1 year, non-T-ALL, BFM risk factor (RF) 2, a modified protocol II, and continuation therapy with triple intrathecal chemotherapy (TIT); IR patients received protocol Ib, HD-MTX 5 g/m2, protocol II and continuation therapy with TIT; HR patients received 9 polychemotherapy blocks, cranial irradiation and continuation therapy. Duration of treatment was 24 months. A randomized study was conducted to evaluate the impact of high-dose asparaginase in non high risk patients: the results of this study cannot be disclosed yet. Results. One thousand one hundred and fifty-two (96.5%) patients achieved CR. Overall EFS (SE) at 5-years was 71.0% (1.4), with a survival of 80.3% (1.3). Relapse occurred in 262 children (21.9%), either in the marrow (n=192 isolated and 32 with other sites, 18.7%). In the CNS (n=18, 1.5%), or elsewhere (n=20, 1.7%). 5-year EFS (SE) was 83.3% (2.4) in SR, 74.7% (1.8) in IR, and 39.7% (3.5) in HR groups, respectively. Interpretation and Conclusions. Overall cure rate was higher than in the previous AIEOP-ALL 88 study. Treatment intensification with polychemotherapy blocks did not improve results in HR. Cranial irradiation can be safely omitted in over 80% of children treated with BFM based chemotherapy.

AB - Background and Objective. Since 1988 the AIEOP has used BFM-based chemotherapy for childhood ALL. Current organization and results and role of cranial irradiation in the AIEOP-ALL 91 study are reported. Design and Methods. From 1991 to 1995, 1194 children ( 1 year, non-T-ALL, BFM risk factor (RF) 2, a modified protocol II, and continuation therapy with triple intrathecal chemotherapy (TIT); IR patients received protocol Ib, HD-MTX 5 g/m2, protocol II and continuation therapy with TIT; HR patients received 9 polychemotherapy blocks, cranial irradiation and continuation therapy. Duration of treatment was 24 months. A randomized study was conducted to evaluate the impact of high-dose asparaginase in non high risk patients: the results of this study cannot be disclosed yet. Results. One thousand one hundred and fifty-two (96.5%) patients achieved CR. Overall EFS (SE) at 5-years was 71.0% (1.4), with a survival of 80.3% (1.3). Relapse occurred in 262 children (21.9%), either in the marrow (n=192 isolated and 32 with other sites, 18.7%). In the CNS (n=18, 1.5%), or elsewhere (n=20, 1.7%). 5-year EFS (SE) was 83.3% (2.4) in SR, 74.7% (1.8) in IR, and 39.7% (3.5) in HR groups, respectively. Interpretation and Conclusions. Overall cure rate was higher than in the previous AIEOP-ALL 88 study. Treatment intensification with polychemotherapy blocks did not improve results in HR. Cranial irradiation can be safely omitted in over 80% of children treated with BFM based chemotherapy.

KW - Acute lymphoblastic leukemia

KW - BFM chemotherapy

KW - Children

KW - Cranial irradiation

KW - Prognostic factors

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