Long-term results of the AIEOP-ALL-95 trial for childhood acute lymphoblastic leukemia: Insight on the prognostic value of DNA index in the framework of Berlin-Frankfurt-Muenster-based chemotherapy

Maurizio Aricò, Maria Grazia Valsecchi, Carmelo Rizzari, Elena Barisone, Andrea Biondi, Fiorina Casale, Franco Locatelli, Luca Lo Nigro, Matteo Luciani, Chiara Messina, Concetta Micalizzi, Rosanna Parasole, Andrea Pession, Nicola Santoro, Anna Maria Testi, Daniela Silvestri, Giuseppe Basso, Giuseppe Masera, Valentino Conter

Research output: Contribution to journalArticle

Abstract

Purpose: Between May 1995 and August 2000 the Associazione Italiana di Ematologia Oncologia Pediatrica conducted the ALL-95 study for risk-directed, Berlin-Frankfurt-Muenster (BFM) -oriented therapy of childhood acute lymphoblastic leukemia, aimed at exploring treatment reduction in standard-risk patients (SR) and intensification during continuation therapy in intermediate-risk patients (IR) as randomized questions and treatment intensification in high-risk patients (HR). The prognostic value of DNA index was explored in this setting. Patients and Methods: A total of 1,744 patients were enrolled (115, SR; 1,385, IR; and 244, HR). SR patients (DNA index ≥ 1.16 and <1.60; age, 1 to 5 years; and WBC <20,000, non-T- immunophenotype, with no high-risk features) received a reduced induction therapy (no anthracyclines); IR patients were randomly assigned to receive or not receive vincristine and dexamethasone pulses during maintenance; HR therapy was based on a conventional BFM schedule intensified with three chemotherapy blocks followed by a double reinduction phase. Results: The event-free survival and overall survival probabilities at 10 years for the entire group were 72.5% (SE, 1.3) and 83.6% (SE, 0.9); 85.0% (SE, 3.4) and 95.5% (SE, 2.0) in SR, 75.1% (SE, 1.5) and 87.5% (SE, 0.9) in IR, and 51.0% (SE, 3.2) and 57.2% (SE, 3.3) in HR patients, respectively. Patients with a favorable DNA index had superior EFS in both IR (83.8% [2.7%] v 73.9% [1.7%]) and in HR (67.8% [9.4%] and 49.6% [3.5%]). Of the six patients with DNA index less than 0.8, only one remained in remission. Conclusion: Favorable DNA index was associated with a better prognosis in IR and HR patients defined by presenting clinical criteria and treatment with a BFM-oriented chemotherapy.

Original languageEnglish
Pages (from-to)283-289
Number of pages7
JournalJournal of Clinical Oncology
Volume26
Issue number2
DOIs
Publication statusPublished - Jan 10 2008

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Drug Therapy
DNA
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Long-term results of the AIEOP-ALL-95 trial for childhood acute lymphoblastic leukemia : Insight on the prognostic value of DNA index in the framework of Berlin-Frankfurt-Muenster-based chemotherapy. / Aricò, Maurizio; Valsecchi, Maria Grazia; Rizzari, Carmelo; Barisone, Elena; Biondi, Andrea; Casale, Fiorina; Locatelli, Franco; Lo Nigro, Luca; Luciani, Matteo; Messina, Chiara; Micalizzi, Concetta; Parasole, Rosanna; Pession, Andrea; Santoro, Nicola; Testi, Anna Maria; Silvestri, Daniela; Basso, Giuseppe; Masera, Giuseppe; Conter, Valentino.

In: Journal of Clinical Oncology, Vol. 26, No. 2, 10.01.2008, p. 283-289.

Research output: Contribution to journalArticle

Aricò, M, Valsecchi, MG, Rizzari, C, Barisone, E, Biondi, A, Casale, F, Locatelli, F, Lo Nigro, L, Luciani, M, Messina, C, Micalizzi, C, Parasole, R, Pession, A, Santoro, N, Testi, AM, Silvestri, D, Basso, G, Masera, G & Conter, V 2008, 'Long-term results of the AIEOP-ALL-95 trial for childhood acute lymphoblastic leukemia: Insight on the prognostic value of DNA index in the framework of Berlin-Frankfurt-Muenster-based chemotherapy', Journal of Clinical Oncology, vol. 26, no. 2, pp. 283-289. https://doi.org/10.1200/JCO.2007.12.3927
Aricò, Maurizio ; Valsecchi, Maria Grazia ; Rizzari, Carmelo ; Barisone, Elena ; Biondi, Andrea ; Casale, Fiorina ; Locatelli, Franco ; Lo Nigro, Luca ; Luciani, Matteo ; Messina, Chiara ; Micalizzi, Concetta ; Parasole, Rosanna ; Pession, Andrea ; Santoro, Nicola ; Testi, Anna Maria ; Silvestri, Daniela ; Basso, Giuseppe ; Masera, Giuseppe ; Conter, Valentino. / Long-term results of the AIEOP-ALL-95 trial for childhood acute lymphoblastic leukemia : Insight on the prognostic value of DNA index in the framework of Berlin-Frankfurt-Muenster-based chemotherapy. In: Journal of Clinical Oncology. 2008 ; Vol. 26, No. 2. pp. 283-289.
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title = "Long-term results of the AIEOP-ALL-95 trial for childhood acute lymphoblastic leukemia: Insight on the prognostic value of DNA index in the framework of Berlin-Frankfurt-Muenster-based chemotherapy",
abstract = "Purpose: Between May 1995 and August 2000 the Associazione Italiana di Ematologia Oncologia Pediatrica conducted the ALL-95 study for risk-directed, Berlin-Frankfurt-Muenster (BFM) -oriented therapy of childhood acute lymphoblastic leukemia, aimed at exploring treatment reduction in standard-risk patients (SR) and intensification during continuation therapy in intermediate-risk patients (IR) as randomized questions and treatment intensification in high-risk patients (HR). The prognostic value of DNA index was explored in this setting. Patients and Methods: A total of 1,744 patients were enrolled (115, SR; 1,385, IR; and 244, HR). SR patients (DNA index ≥ 1.16 and <1.60; age, 1 to 5 years; and WBC <20,000, non-T- immunophenotype, with no high-risk features) received a reduced induction therapy (no anthracyclines); IR patients were randomly assigned to receive or not receive vincristine and dexamethasone pulses during maintenance; HR therapy was based on a conventional BFM schedule intensified with three chemotherapy blocks followed by a double reinduction phase. Results: The event-free survival and overall survival probabilities at 10 years for the entire group were 72.5{\%} (SE, 1.3) and 83.6{\%} (SE, 0.9); 85.0{\%} (SE, 3.4) and 95.5{\%} (SE, 2.0) in SR, 75.1{\%} (SE, 1.5) and 87.5{\%} (SE, 0.9) in IR, and 51.0{\%} (SE, 3.2) and 57.2{\%} (SE, 3.3) in HR patients, respectively. Patients with a favorable DNA index had superior EFS in both IR (83.8{\%} [2.7{\%}] v 73.9{\%} [1.7{\%}]) and in HR (67.8{\%} [9.4{\%}] and 49.6{\%} [3.5{\%}]). Of the six patients with DNA index less than 0.8, only one remained in remission. Conclusion: Favorable DNA index was associated with a better prognosis in IR and HR patients defined by presenting clinical criteria and treatment with a BFM-oriented chemotherapy.",
author = "Maurizio Aric{\`o} and Valsecchi, {Maria Grazia} and Carmelo Rizzari and Elena Barisone and Andrea Biondi and Fiorina Casale and Franco Locatelli and {Lo Nigro}, Luca and Matteo Luciani and Chiara Messina and Concetta Micalizzi and Rosanna Parasole and Andrea Pession and Nicola Santoro and Testi, {Anna Maria} and Daniela Silvestri and Giuseppe Basso and Giuseppe Masera and Valentino Conter",
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month = "1",
day = "10",
doi = "10.1200/JCO.2007.12.3927",
language = "English",
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pages = "283--289",
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TY - JOUR

T1 - Long-term results of the AIEOP-ALL-95 trial for childhood acute lymphoblastic leukemia

T2 - Insight on the prognostic value of DNA index in the framework of Berlin-Frankfurt-Muenster-based chemotherapy

AU - Aricò, Maurizio

AU - Valsecchi, Maria Grazia

AU - Rizzari, Carmelo

AU - Barisone, Elena

AU - Biondi, Andrea

AU - Casale, Fiorina

AU - Locatelli, Franco

AU - Lo Nigro, Luca

AU - Luciani, Matteo

AU - Messina, Chiara

AU - Micalizzi, Concetta

AU - Parasole, Rosanna

AU - Pession, Andrea

AU - Santoro, Nicola

AU - Testi, Anna Maria

AU - Silvestri, Daniela

AU - Basso, Giuseppe

AU - Masera, Giuseppe

AU - Conter, Valentino

PY - 2008/1/10

Y1 - 2008/1/10

N2 - Purpose: Between May 1995 and August 2000 the Associazione Italiana di Ematologia Oncologia Pediatrica conducted the ALL-95 study for risk-directed, Berlin-Frankfurt-Muenster (BFM) -oriented therapy of childhood acute lymphoblastic leukemia, aimed at exploring treatment reduction in standard-risk patients (SR) and intensification during continuation therapy in intermediate-risk patients (IR) as randomized questions and treatment intensification in high-risk patients (HR). The prognostic value of DNA index was explored in this setting. Patients and Methods: A total of 1,744 patients were enrolled (115, SR; 1,385, IR; and 244, HR). SR patients (DNA index ≥ 1.16 and <1.60; age, 1 to 5 years; and WBC <20,000, non-T- immunophenotype, with no high-risk features) received a reduced induction therapy (no anthracyclines); IR patients were randomly assigned to receive or not receive vincristine and dexamethasone pulses during maintenance; HR therapy was based on a conventional BFM schedule intensified with three chemotherapy blocks followed by a double reinduction phase. Results: The event-free survival and overall survival probabilities at 10 years for the entire group were 72.5% (SE, 1.3) and 83.6% (SE, 0.9); 85.0% (SE, 3.4) and 95.5% (SE, 2.0) in SR, 75.1% (SE, 1.5) and 87.5% (SE, 0.9) in IR, and 51.0% (SE, 3.2) and 57.2% (SE, 3.3) in HR patients, respectively. Patients with a favorable DNA index had superior EFS in both IR (83.8% [2.7%] v 73.9% [1.7%]) and in HR (67.8% [9.4%] and 49.6% [3.5%]). Of the six patients with DNA index less than 0.8, only one remained in remission. Conclusion: Favorable DNA index was associated with a better prognosis in IR and HR patients defined by presenting clinical criteria and treatment with a BFM-oriented chemotherapy.

AB - Purpose: Between May 1995 and August 2000 the Associazione Italiana di Ematologia Oncologia Pediatrica conducted the ALL-95 study for risk-directed, Berlin-Frankfurt-Muenster (BFM) -oriented therapy of childhood acute lymphoblastic leukemia, aimed at exploring treatment reduction in standard-risk patients (SR) and intensification during continuation therapy in intermediate-risk patients (IR) as randomized questions and treatment intensification in high-risk patients (HR). The prognostic value of DNA index was explored in this setting. Patients and Methods: A total of 1,744 patients were enrolled (115, SR; 1,385, IR; and 244, HR). SR patients (DNA index ≥ 1.16 and <1.60; age, 1 to 5 years; and WBC <20,000, non-T- immunophenotype, with no high-risk features) received a reduced induction therapy (no anthracyclines); IR patients were randomly assigned to receive or not receive vincristine and dexamethasone pulses during maintenance; HR therapy was based on a conventional BFM schedule intensified with three chemotherapy blocks followed by a double reinduction phase. Results: The event-free survival and overall survival probabilities at 10 years for the entire group were 72.5% (SE, 1.3) and 83.6% (SE, 0.9); 85.0% (SE, 3.4) and 95.5% (SE, 2.0) in SR, 75.1% (SE, 1.5) and 87.5% (SE, 0.9) in IR, and 51.0% (SE, 3.2) and 57.2% (SE, 3.3) in HR patients, respectively. Patients with a favorable DNA index had superior EFS in both IR (83.8% [2.7%] v 73.9% [1.7%]) and in HR (67.8% [9.4%] and 49.6% [3.5%]). Of the six patients with DNA index less than 0.8, only one remained in remission. Conclusion: Favorable DNA index was associated with a better prognosis in IR and HR patients defined by presenting clinical criteria and treatment with a BFM-oriented chemotherapy.

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