title: Overview of clinical studies of childhood acute lymphoblastic leukemia for more than ten years by the Japanese Children's Cancer and Leukemia Study Group.
abstract: Since 1981, the Children's Cancer and Leukemia Study Group (CCLSG) has developed a series of protocols for treatment of acute lymphoblastic leukemia (ALL) in childhood. In the first randomized controlled study of the 811 protocol (1981-1983) a comparison of conventional daily 6-mercaptopurine and methotrexate with a pulsed regimen of the two drugs was performed. The superiority of the pulsed regimen was shown. In the next 841 protocol (1984-1987) a comparison of two drugs and three drugs during induction therapy was conducted. The three-drug regimen resulted in a significantly higher event-free survival (EFS) rate. In the 874 protocol (1987-1990) two regimens with or without cranial irradiation were randomly compared, and there was no significant difference between the two regimens for the standard-risk group. To further improve the EFS rate a risk group-directed protocol 911 was conducted starting in January 1991. Life-table analysis of serial CCLSG protocols revealed that the outcome of overall ALL has gradually improved with an increase of the EFS rate; 41.4% +/- 3.6% at 14 years for the 811 protocol, 51.3% +/- 3.5% at 11 years for the 841 protocol, 56.7% +/- 3.1% at 8 years for the 874 protocol, and 78.2% +/- 3.1% at 4 years for the more recent 911 protocol.
authors.affiliation: Department of Pediatrics, Kanazawa University School of Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Koizumi
authors.forename: T
authors.initials: T
authors.lastname: Fujimoto
authors.forename: T
authors.initials: T
authors.lastname: Oka
authors.forename: S
authors.initials: S
authors.lastname: Watanabe
authors.forename: A
authors.initials: A
authors.lastname: Kikuta
authors.forename: T
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: T
authors.initials: T
authors.lastname: Matsushita
authors.forename: K
authors.initials: K
authors.lastname: Asami
authors.forename: T
authors.initials: T
authors.lastname: Yanase
authors.forename: J
authors.initials: J
authors.lastname: Mimaya
authors.forename: S
authors.initials: S
authors.lastname: Ohta
authors.forename: M
authors.initials: M
authors.lastname: Miyake
authors.forename: K
authors.initials: K
authors.lastname: Nishikawa
authors.forename: T
authors.initials: T
authors.lastname: Furuyama
authors.forename: Y
authors.initials: Y
authors.lastname: Yamamura
authors.forename: Y
authors.initials: Y
authors.lastname: Takaue
authors.forename: T
authors.initials: T
authors.lastname: Ninomiya
authors.forename: T
authors.initials: T
authors.lastname: Shimokawa
authors.forename: A
authors.initials: A
authors.lastname: Iwai
authors.forename: Y
authors.initials: Y
authors.lastname: Ishida
authors.forename: N
authors.initials: N
authors.lastname: Ariyoshi
authors.forename: K
authors.initials: K
authors.lastname: Kimura
authors.forename: K
authors.initials: K
authors.lastname: Kawakami
authors.forename: T
authors.initials: T
authors.lastname: Gushiken
authors.forename: I
authors.initials: I
authors.lastname: Sekine
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D015993:Life Tables; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome