[Adolescents with acute lymphatic leukaemia achieve significantly better results when treated following Dutch paediatric oncology protocols than with adult protocols].
OBJECTIVE
To compare the results, in adolescents with acute lymphatic leukaemia (ALL), of treatment according to the protocols of the Netherlands Foundation for Paediatric Oncology (DCOG) or according to the protocols for adults of the Dutch Foundation for Adult Haemato-Oncology (HOVON).


METHODS
Retrospective.


METHODS
During the period from May 1985 to November 1999, 120 15-20-year-old adolescents with ALL were treated: 47 according to a DCOG protocol and 73 according to a HOVON protocol. The records of the integrated cancer centres indicate that this represented about two-thirds of all known adolescents with ALL in the Netherlands.


RESULTS
Adolescents with ALL treated according to the DCOG protocols had significantly better 5-year survival rates (79% versus 38%), a significantly lower probability of relapse (27% versus 55%) and a lower treatment-related mortality (4% versus 25%) than the adolescents treated according to the HOVON protocols.


CONCLUSIONS
This difference in outcome was most likely related to differences in structure and content between the DCOG and HOVON protocols. The HOVON protocols consisted of relatively short, intensive chemotherapy, often followed by autologous or allogeneic bone-marrow transplantation. Several treatment elements present in the DCOG protocols, such as high-dose methotrexate, reinduction therapy and maintenance therapy were absent in the HOVON protocols. Moreover, the cumulative dosages of dexamethasone, mercaptopurine, asparaginase and vincristine were lower in the HOVON protocols.
de Bont
J M
JM
Locatie Sophia Kinderziekenhuis, afd. Kinderoncologie en -hematologie, Erasmus Medisch Centrum, Rotterdam.
van der Holt
B
B
Dekker
A W
AW
van der Does-van den Berg
A
A
Sonneveld
P
P
Pieters
R
R
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome