title: [T-cell pediatric acute lymphoblastic leukemia: analysis of survival and prognostic factors in 4 consecutive protocols of the Spanish cooperative study group SHOP].
abstract: OBJECTIVE
  Acute lymphoblastic leukemia (ALL) is the most frequent cancer in childhood, with cure rates of 80-85%. In T-cell ALL (15% of ALL), prognostic factors are ill defined. We aimed to describe the event-free survival (EFS) and analyze clinical prognostic factors in a series of pediatric T-ALL of 4 consecutive clinical trials.
  
  
  METHODS
  Children with T-ALL aged 1-18 years treated in 37 institutions in Spain were enrolled in 4 consecutive trials from February-1989 to November-2009.
  
  
  RESULTS
  A total of 218 T-ALL patients out of 1,652 pediatric ALL were evaluable during the study period (SHOP/ALL-89: 35, ALL-94: 63, ALL-99: 62, ALL-2005: 58). There were 164 boys (75%). Median age (years) was 7.8 range (1.3-18.6). Median leukocytes (10(9)/L) was 78.2, range 0.8-930. Fifteen (6.8%) children had central nervous system (CNS) involvement at diagnosis. Regarding response to induction treatment, 150 (75%) patients had less than 5% blasts on day-14 bone marrow and 199 achieved complete remission at the end of induction. Overall survival (OS) at 60 months for SHOP/ALL-89, ALL-94, ALL-99 was 48 (8), 49 (6), 70 (6) %, respectively, and at 48 months for SHOP/ALL-2005 (ongoing protocol) was 74 (8) %. Median follow-up (months) was 206, 152, 74 and 17 respectively. Analysis of prognostic factors revealed no statistical differences regarding sex or age. Leukocyte count over 200×10(9)/l (P=.024), CNS infiltration at diagnosis (P<.006) and treatment response had prognostic significance (end-induction complete remission) (P=.0000), day 14-bone marrow (P=.005).
  
  
  CONCLUSIONS
  Results for the SHOP/ALL-89 and ALL-94 protocols were inferior to other contemporary protocols but there has been an improvement in survival in the 2 last trials. In line with other T-ALL series, response to treatment had the strongest prognostic impact.
authors.affiliation: Hematología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, España. srives@hsjdbcn.org
authors.forename: Susana
authors.initials: S
authors.lastname: Rives
authors.forename: Jesús
authors.initials: J
authors.lastname: Estella
authors.forename: Mireia
authors.initials: M
authors.lastname: Camós
authors.forename: Purificación
authors.initials: P
authors.lastname: García-Miguel
authors.forename: Amparo
authors.initials: A
authors.lastname: Verdeguer
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Couselo
authors.forename: María
authors.initials: M
authors.lastname: Tasso
authors.forename: Javier
authors.initials: J
authors.lastname: Molina
authors.forename: Pedro
authors.initials: P
authors.lastname: Gómez
authors.forename: Rafael
authors.initials: R
authors.lastname: Fernández-Delgado
authors.forename: Aurora
authors.initials: A
authors.lastname: Navajas
authors.forename: Isabel
authors.initials: I
authors.lastname: Badell
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D060830:Consolidation Chemotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy; D007223:Infant; D060046:Maintenance Chemotherapy; D008297:Male; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D013030:Spain; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents