title: Treatment of relapsed precursor-B acute lymphoblastic leukemia with intensive chemotherapy: POG (Pediatric Oncology Group) study 9411 (SIMAL 9).
abstract: Pediatric patients who experience a bone marrow relapse of precursor-B acute lymphoblastic leukemia are cured <50% of the time. This study was designed to determine if intensification of therapies with known activity in this disease would improve the cure rates for patients with relapsed acute lymphoblastic leukemia. Patients were treated with intensive asparaginase during induction followed by repeated cycles of ifosfamide/etoposide and cytarabine/idarubicin. Patients with well-matched related donors were encouraged to undergo hematopoietic stem cell transplant as consolidation. The results of this study demonstrate no significant difference in disease-free survival in patients who received chemotherapy alone (45%) or chemotherapy followed by allogeneic stem cell transplant (50%). Furthermore, results from this study show no significant difference in event-free survival (39.9%±6.2%) or overall survival (41.6%±6.1%) at 8 years when compared with previous studies using less intensive regimens. Our results suggest that alternative therapies are needed to improve cure rates for pediatric patients with relapsed leukemia.
authors.affiliation: *Division of Pediatric Hematology/Oncology/Bone Marrow Transplant, Medical College of Wisconsin ‡Medical Sciences Institute, BloodCenter of Wisconsin, Milwaukee, WI †Department of Biostatistics, University of Florida, Gainesville #Department of Pediatric Oncology & Hematology, Nemours Children's Clinic, Jacksonville, FL ∥Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA ¶Department of Pediatric Hematology-Oncology, University of Vermont, Burlington, VT **Department of Pediatric Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, TX §IWK Health Center, Halifax, NS, Canada.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Kelly
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Lu
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Devidas
authors.forename: Bruce
authors.initials: B
authors.lastname: Camitta
authors.forename: Thomas
authors.initials: T
authors.lastname: Abshire
authors.forename: Mark L
authors.initials: ML
authors.lastname: Bernstein
authors.forename: Amy
authors.initials: A
authors.lastname: Billett
authors.forename: Alan
authors.initials: A
authors.lastname: Homans
authors.forename: Eric
authors.initials: E
authors.lastname: Sandler
authors.forename: George
authors.initials: G
authors.lastname: Buchanan
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality; D012008:Recurrence; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents