Linked Life Data

15251979

Source:http://linkedlifedata.com/resource/pubmed/id/15251979

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
9
pubmed:dateCreated
2004-10-22
pubmed:abstractText
St Jude Total Therapy Study XIIIB for childhood acute lymphoblastic leukemia (ALL) incorporated more stringent risk classification, early intensification of intrathecal chemotherapy, reinduction treatment, and the addition of dexamethasone to postremission therapy to increase the proportion of event-free survivors without jeopardizing their quality of life. Cranial irradiation was reserved for the 12% of patients who had T-cell ALL and a presenting leukocyte count of 100 x 10(9)/L or more, or CNS-3 (5 or more leukocytes/microL with identifiable blast cells in an atraumatic sample or the presence of cranial nerve palsy) status. Among the 247 consecutive patients enrolled in the study, 117 were classified as having lower-risk leukemia and received mainly antimetabolite-based continuation therapy; the 130 cases with higher-risk leukemia received more intensive continuation chemotherapy with multiple drug pairs administered in weekly rotation. The 5-year event-free survival estimate was 80.8% +/- 2.6% (SE); the 8-year rate was 78.6% +/- 5.8%. The 5-year cumulative risk of an isolated central nervous system (CNS) relapse was 1.7% +/- 0.8%, and that of isolated plus combined CNS relapse was 3.0% +/- 1.1%. The 5-year cumulative risks of etoposide-related myeloid malignancies were 1.8% +/- 1.3% in the lower-risk patients who received a cumulative dose of 1.2 g/m(2) and 5.0% +/- 2.0% in the higher-risk patients who received a cumulative dose of up to 14.4 g/m(2) (P = .18). Independent adverse prognostic features included the presence of MLL-AF4 or BCR-ABL fusion gene and minimal residual leukemia of 0.01% or more at the end of the 6-week remission induction phase. Our results suggest the efficacy of early intensification of intrathecal chemotherapy and provide the basis for studies omitting cranial irradiation altogether.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
0006-4971
pubmed:author
pubmed:issnType
Print
pubmed:day
1
pubmed:volume
104
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2690-6
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:15251979-Adolescent, pubmed-meshheading:15251979-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:15251979-Child, pubmed-meshheading:15251979-Child, Preschool, pubmed-meshheading:15251979-Cranial Irradiation, pubmed-meshheading:15251979-Dexamethasone, pubmed-meshheading:15251979-Disease-Free Survival, pubmed-meshheading:15251979-Etoposide, pubmed-meshheading:15251979-Female, pubmed-meshheading:15251979-Humans, pubmed-meshheading:15251979-Infant, pubmed-meshheading:15251979-Injections, Spinal, pubmed-meshheading:15251979-Leukemia, Myeloid, pubmed-meshheading:15251979-Male, pubmed-meshheading:15251979-Precursor Cell Lymphoblastic Leukemia-Lymphoma, pubmed-meshheading:15251979-Prognosis, pubmed-meshheading:15251979-Recurrence, pubmed-meshheading:15251979-Risk Assessment, pubmed-meshheading:15251979-Treatment Outcome
pubmed:year
2004
pubmed:articleTitle
Improved outcome for children with acute lymphoblastic leukemia: results of Total Therapy Study XIIIB at St Jude Children's Research Hospital.
pubmed:affiliation
Department of Hematology/Oncology, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. ching-hon.pui@stjude.org
pubmed:publicationType
Journal Article, Clinical Trial, Research Support, U.S. Gov't, P.H.S., Research Support, Non-U.S. Gov't