title: [Age-related characteristics of the efficacy of different glucocorticosteroids in the therapy of acute lymphoblastic leukemia].
abstract: OBJECTIVE
  To determine predictors for decision-making on a differential approach to choosing glucocorticosteroids (GCS) for children and adolescents with acute lymphoblastic leukemia (ALL).
  
  
  METHODS
  The analysis covered 1064 primary patients aged to 1 to 18 years with ALL who had been registered at the clinics of Russia and Belorussia in April 2002 to November 2006. Before induction therapy, the patients were randomized into a dexamethasone (DEXA) 6 mg/m2 group (n=539) and a methylprednisolone (MePRED) 60 mg/m2 one (n=525).
  
  
  RESULTS
  The entire group showed no statistically significant differences in survival rates between the patients receiving DEXA or MePRED. However, an analysis of age groups revealed the benefits of DEXA in children younger than 14 years (the event-free survival (EFS) was 76±2 and 71±2%, respectively (p=0.048); the overall survival (OS) was 81±2 and 77±2%, respectively (p=0.046); therapy-induced mortality was 6.4% (DEXA) andl 1.1% (MePRED) (p=0.01 4); the rate of isolated extramedullary relapses was 1.5% (DEXA) and 4.4% (MePRED) (p=0.009). At the same time, EFS and OS in 14-to-18-year-old adolescents were statistically significantly higher than in those who used MePRED (EFS, 65±6 and 52±6%, respectively (p=0.087); OS, 72±6 and 61±6%, respectively; (p=0.l 7).
  
  
  CONCLUSIONS
  The findings suggest that it is possible that the choice of a GCS for ALL therapy must be also based on a patient's age. There is a need for further studies of this matter in prospective randomized multicenter trials in children and adolescents.
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: A I
authors.initials: AI
authors.lastname: Karachunsky
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: Yu V
authors.initials: YV
authors.lastname: Rumyantseva
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia.
authors.forename: S N
authors.initials: SN
authors.lastname: Lagoiko
authors.affiliation: Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Bührer
authors.affiliation: Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Tallen
authors.affiliation: Republican Research and Practical Center for Pediatric Oncology and Hematology, Minsk, Belarus.
authors.forename: O V
authors.initials: OV
authors.lastname: Aleinikova
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; Republican Research and Practical Center for Pediatric Oncology and Hematology, Minsk, Belarus.
authors.forename: O I
authors.initials: OI
authors.lastname: Bydanov
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia.
authors.forename: N V
authors.initials: NV
authors.lastname: Korepanova
authors.affiliation: Russian Children's Clinical Hospital, Ministry of Health of Russia, Moscow, Russia.
authors.forename: L V
authors.initials: LV
authors.lastname: Baidun
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia.
authors.forename: T V
authors.initials: TV
authors.lastname: Nasedkina
authors.affiliation: Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: A Von
authors.initials: AV
authors.lastname: Stackelberg
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: G A
authors.initials: GA
authors.lastname: Novichkova
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: A A
authors.initials: AA
authors.lastname: Maschan
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: D V
authors.initials: DV
authors.lastname: Litvinov
authors.affiliation: Russian Children's Clinical Hospital, Ministry of Health of Russia, Moscow, Russia.
authors.forename: N I
authors.initials: NI
authors.lastname: Ponomareva
authors.affiliation: N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia; Morozov City Children's Clinical Hospital, Moscow Healthcare Department, Moscow, Russia.
authors.forename: K L
authors.initials: KL
authors.lastname: Kondratchik
authors.affiliation: N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: E G
authors.initials: EG
authors.lastname: Mansurova
authors.affiliation: Regional Children's Clinical Hospital One, Yekaterinburg, Russia.
authors.forename: L G
authors.initials: LG
authors.lastname: Fechina
authors.affiliation: Regional Children's Clinical Hospital One, Yekaterinburg, Russia.
authors.forename: O V
authors.initials: OV
authors.lastname: Streneva
authors.affiliation: Voronezh Regional Children's Clinical Hospital One, Voronezh, Russia.
authors.forename: N B
authors.initials: NB
authors.lastname: Yudina
authors.affiliation: Nizhnevartovsk District Children's Clinical Hospital, Nizhnevartovsk, Khanty-Mansi Autonomic District-Yugra, Russia.
authors.forename: G R
authors.initials: GR
authors.lastname: Sharapova
authors.affiliation: Nizhny Novgorod Regional Children's Clinical Hospital, Nizhny Novgorod, Russia.
authors.forename: A V
authors.initials: AV
authors.lastname: Shamardina
authors.affiliation: Tomsk Regional Clinical Hospital, Tomsk, Russia.
authors.forename: I E
authors.initials: IE
authors.lastname: Gerbek
authors.affiliation: Orenburg Regional Clinical Oncology Dispensary, Orenburg, Russia.
authors.forename: A P
authors.initials: AP
authors.lastname: Shapochnik
authors.affiliation: D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia.
authors.forename: A G
authors.initials: AG
authors.lastname: Rumyantsev
authors.affiliation: Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Henze
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000453:epidemiology; D011446:Prospective Studies; D002094:Republic of Belarus / Q000453:epidemiology; D012426:Russia / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D008775:Methylprednisolone