Long-term results of dana-farber cancer institute all consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000)

L. B. Silverman, K. E. Stevenson, J. E. O'Brien, B. L. Asselin, R. D. Barr, L. Clavell, P. D. Cole, K. M. Kelly, C. Laverdiere, B. Michon, M. A. Schorin, C. L. Schwartz, E. W. O'Holleran, D. S. Neuberg, H. J. Cohen, S. E. Sallan

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Abstract

The Dana-Farber Cancer Institute (DFCI) acute lymphoblastic leukemia (ALL) Consortium has been conducting multi-institutional clinical trials in childhood ALL since 1981. The treatment backbone has included 20-30 consecutive weeks of asparaginase during intensification and frequent vincristine/corticosteroid pulses during the continuation phase. Between 1985 and 2000, 1457 children aged 0-18 years were treated on four consecutive protocols: 85-01 (1985-1987), 87-01 (1987-1991), 91-01 (1991-1955) and 95-01 (1996-2000). The 10-year event-free survival (EFS)s.e. by protocol was 77.92.8% (85-01), 74.22.3% (87-01), 80.82.1% (91-01) and 80.51.8% (95-01). Approximately 82% of patients treated in the 1980s and 88% treated in the 1990s were long-term survivors. Both EFS and overall survival (OS) rates were significantly higher for patients treated in the 1990s compared with the 1980s (P0.05 and 0.01, respectively). On the two protocols conducted in the 1990s, EFS was 79-85% for T-cell ALL patients and 75-78% for adolescents (age 10-18 years). Results of randomized studies revealed that dexrazoxane prevented acute cardiac injury without adversely affecting EFS or OS in high-risk (HR) patients, and frequently dosed intrathecal chemotherapy was an effective substitute for cranial radiation in standard-risk (SR) patients. Current studies continue to focus on improving efficacy while minimizing acute and late toxicities.

Original languageEnglish (US)
Pages (from-to)320-334
Number of pages15
JournalLeukemia
Volume24
Issue number2
DOIs
StatePublished - Feb 2010

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Disease-Free Survival
Neoplasms
Dexrazoxane
Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
Asparaginase
Vincristine
Survivors
Adrenal Cortex Hormones
Survival Rate
Clinical Trials
Radiation
Drug Therapy
Survival
Wounds and Injuries
Therapeutics

Keywords

  • Acute lymphoblastic leukemia
  • Anthracycline
  • Asparaginase
  • Long-term follow-up

ASJC Scopus subject areas

  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine

Cite this

Silverman, L. B., Stevenson, K. E., O'Brien, J. E., Asselin, B. L., Barr, R. D., Clavell, L., ... Sallan, S. E. (2010). Long-term results of dana-farber cancer institute all consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000). Leukemia, 24(2), 320-334. https://doi.org/10.1038/leu.2009.253

Long-term results of dana-farber cancer institute all consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000). / Silverman, L. B.; Stevenson, K. E.; O'Brien, J. E.; Asselin, B. L.; Barr, R. D.; Clavell, L.; Cole, P. D.; Kelly, K. M.; Laverdiere, C.; Michon, B.; Schorin, M. A.; Schwartz, C. L.; O'Holleran, E. W.; Neuberg, D. S.; Cohen, H. J.; Sallan, S. E.

In: Leukemia, Vol. 24, No. 2, 02.2010, p. 320-334.

Research output: Contribution to journalArticle

Silverman, LB, Stevenson, KE, O'Brien, JE, Asselin, BL, Barr, RD, Clavell, L, Cole, PD, Kelly, KM, Laverdiere, C, Michon, B, Schorin, MA, Schwartz, CL, O'Holleran, EW, Neuberg, DS, Cohen, HJ & Sallan, SE 2010, 'Long-term results of dana-farber cancer institute all consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000)', Leukemia, vol. 24, no. 2, pp. 320-334. https://doi.org/10.1038/leu.2009.253
Silverman, L. B. ; Stevenson, K. E. ; O'Brien, J. E. ; Asselin, B. L. ; Barr, R. D. ; Clavell, L. ; Cole, P. D. ; Kelly, K. M. ; Laverdiere, C. ; Michon, B. ; Schorin, M. A. ; Schwartz, C. L. ; O'Holleran, E. W. ; Neuberg, D. S. ; Cohen, H. J. ; Sallan, S. E. / Long-term results of dana-farber cancer institute all consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000). In: Leukemia. 2010 ; Vol. 24, No. 2. pp. 320-334.
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abstract = "The Dana-Farber Cancer Institute (DFCI) acute lymphoblastic leukemia (ALL) Consortium has been conducting multi-institutional clinical trials in childhood ALL since 1981. The treatment backbone has included 20-30 consecutive weeks of asparaginase during intensification and frequent vincristine/corticosteroid pulses during the continuation phase. Between 1985 and 2000, 1457 children aged 0-18 years were treated on four consecutive protocols: 85-01 (1985-1987), 87-01 (1987-1991), 91-01 (1991-1955) and 95-01 (1996-2000). The 10-year event-free survival (EFS)s.e. by protocol was 77.92.8{\%} (85-01), 74.22.3{\%} (87-01), 80.82.1{\%} (91-01) and 80.51.8{\%} (95-01). Approximately 82{\%} of patients treated in the 1980s and 88{\%} treated in the 1990s were long-term survivors. Both EFS and overall survival (OS) rates were significantly higher for patients treated in the 1990s compared with the 1980s (P0.05 and 0.01, respectively). On the two protocols conducted in the 1990s, EFS was 79-85{\%} for T-cell ALL patients and 75-78{\%} for adolescents (age 10-18 years). Results of randomized studies revealed that dexrazoxane prevented acute cardiac injury without adversely affecting EFS or OS in high-risk (HR) patients, and frequently dosed intrathecal chemotherapy was an effective substitute for cranial radiation in standard-risk (SR) patients. Current studies continue to focus on improving efficacy while minimizing acute and late toxicities.",
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