title: [The prospects for children with acute lymphoblastic leukemia of being cured has increased in the Czech Republic in the 21st century to 90% - outcome of the ALL-IC BFM 2002 trial].
abstract: BACKGROUND
  Acute lymphoblastic leukemia (ALL) is the most frequent childhood malignancy. Treatment has been unified in the middle of 1980 in the Czech Republic. In 2002-2007 children and adolescents with acute lymphoblastic leukemia were treated in an international randomized trial ALL-IC BFM 2002 in the Czech Republic. 291 patients aged 1-18 years were enrolled; infants below 1 year entered a separate trial.
  
  
  RESULTS
  Patients were stratified into three risk groups according to their age, initial leukocyte count, prednisone response, presence of fusion genes BCR/ABL or MLL/AF4, bone marrow D+15 and remission status D+33. The whole therapy took 24 months. Randomized late intensification compared standard BFM therapy with extended, usually more intensive experimental treatment. The median follow-up was 8.7 years. Complete remission was achieved in 97.9% patients, 1% died in remission. 11% of children relapsed, 1.7% with CNS involvement. Six children (2.1%) developed secondary malignancy. Event free survival (EFS) 8 years from diagnosis was 83.5%, overall survival (OS) 91.4%. EFS and OS of the risk groups were: standard risk: 89.4%; 98.1%; intermediate risk: 82.6%; 89.6%; high risk: 68.8%; 78.1%. Male sex and age above 10 years were adverse prognostic factors.
  
  
  CONCLUSIONS
  In comparison with the previous trial ALL-BFM 95, significant improvement was achieved.
authors.forename: Kateřina
authors.initials: K
authors.lastname: Zdráhalová
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Štěrba
authors.forename: Jiří
authors.initials: J
authors.lastname: Domanský
authors.forename: Bohumír
authors.initials: B
authors.lastname: Blažek
authors.forename: Hana
authors.initials: H
authors.lastname: Ptoszková
authors.forename: Vladimír
authors.initials: V
authors.lastname: Mihál
authors.forename: Zbyněk
authors.initials: Z
authors.lastname: Novák
authors.forename: Jiří
authors.initials: J
authors.lastname: Hak
authors.forename: Daniela
authors.initials: D
authors.lastname: Procházková
authors.forename: Zdena
authors.initials: Z
authors.lastname: Černá
authors.forename: Pavel
authors.initials: P
authors.lastname: Timr
authors.forename: Yahia
authors.initials: Y
authors.lastname: Jabali
authors.forename: Petr
authors.initials: P
authors.lastname: Sedláček
authors.forename: Petr
authors.initials: P
authors.lastname: Smíšek
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Zemanová
authors.forename: Marie
authors.initials: M
authors.lastname: Jarošová
authors.forename: Alena
authors.initials: A
authors.lastname: Houdková
authors.forename: Ester
authors.initials: E
authors.lastname: Mejstříková
authors.forename: Ondřej
authors.initials: O
authors.lastname: Hrušák
authors.forename: Jan
authors.initials: J
authors.lastname: Zuna
authors.forename: Iveta
authors.initials: I
authors.lastname: Janotová
authors.forename: Jan
authors.initials: J
authors.lastname: Trka
authors.forename: Jan
authors.initials: J
authors.lastname: Starý
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001215:Asparaginase / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D018153:Czech Republic; D003630:Daunorubicin / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D015996:Survival Rate; D013866:Thioguanine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D001215:Asparaginase; D013866:Thioguanine; D011241:Prednisone; D003630:Daunorubicin
keywords: acute lymphoblastic leukemia - children - chemotherapy - protocol ALL-IC BFM 2002.