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

Research output: Contribution to journalArticlepeer-review


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
Issue number9
Publication statusPublished - Sep 1998


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

ASJC Scopus subject areas

  • Hematology


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