title: Long-term outcomes for children with acute lymphoblastic leukemia (ALL) treated on The Cancer Institute of New Jersey ALL trial (CINJALL).
abstract: The Cancer Institute of New Jersey Acute Lymphoblastic Leukemia trial (CINJALL) employed a post-induction regimen centered on intensive oral antimetabolite therapy, with no intravenous methotrexate (MTX). Fifty-eight patients enrolled between 2001 and 2005. A high rate of induction death (n = 3) or induction failure (n = 1) was observed. Among those who entered remission, five-year DFS is 80 ± 8.9% for those at standard risk of relapse and 76 ± 7.8% for high-risk patients, with median follow up over six years. The estimated cumulative incidence of testicular relapse among boys was elevated (13 ± 7.2%) compared to the rate observed on contemporary protocols. We conclude that post-induction therapy using intensive oral antimetabolites for children with acute lymphoblastic leukemia (ALL) can result in overall long-term DFS comparable to that observed among children treated with regimens including intravenous MTX. However, an increased risk of late extramedullary relapse among boys was observed, supporting the prevailing opinion that high-dose MTX improves outcome for children with ALL.
authors.affiliation: a Department of Pediatric Hematology/Oncology , The Cancer Institute of New Jersey , New Brunswick , NJ , USA ;
authors.forename: Richard A
authors.initials: RA
authors.lastname: Drachtman
authors.affiliation: a Department of Pediatric Hematology/Oncology , The Cancer Institute of New Jersey , New Brunswick , NJ , USA ;
authors.forename: Margaret
authors.initials: M
authors.lastname: Masterson
authors.affiliation: a Department of Pediatric Hematology/Oncology , The Cancer Institute of New Jersey , New Brunswick , NJ , USA ;
authors.forename: Angela
authors.initials: A
authors.lastname: Shenkerman
authors.affiliation: b Department of Pediatrics , Albert Einstein College of Medicine , Bronx , NY , USA ;
authors.forename: Veena
authors.initials: V
authors.lastname: Vijayanathan
authors.affiliation: b Department of Pediatrics , Albert Einstein College of Medicine , Bronx , NY , USA ;|c The Children's Hospital at Montefiore , Bronx , NY , USA.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Cole
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D060830:Consolidation Chemotherapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D011110:Polymorphism, Genetic; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D013736:Testicular Neoplasms / Q000556:secondary; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C573423:MTHFR protein, human; D042965:Methylenetetrahydrofolate Reductase (NADPH2)
keywords: Acute lymphoblastic leukemia; Hispanic; clinical trials; methotrexate; testicular relapse