T-cell acute lymphoblastic leukemia in patients 1–45 years treated with the pediatric NOPHO ALL2008 protocol
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T-cell acute lymphoblastic leukemia in patients 1–45 years treated with the pediatric NOPHO ALL2008 protocol. / Quist-Paulsen, P.; Toft, N.; Heyman, M.; Abrahamsson, J.; Griškevičius, L.; Hallböök, H.; Jónsson, G.; Palk, K.; Vaitkeviciene, G.; Vettenranta, K.; Åsberg, A.; Frandsen, T. L.; Opdahl, S.; Marquart, H. V.; Siitonen, S.; Osnes, L. T.; Hultdin, M.; Overgaard, U. M.; Wartiovaara-Kautto, U.; Schmiegelow, K.
In: Leukemia, Vol. 34, No. 2, 2020, p. 347-357.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - T-cell acute lymphoblastic leukemia in patients 1–45 years treated with the pediatric NOPHO ALL2008 protocol
AU - Quist-Paulsen, P.
AU - Toft, N.
AU - Heyman, M.
AU - Abrahamsson, J.
AU - Griškevičius, L.
AU - Hallböök, H.
AU - Jónsson, G.
AU - Palk, K.
AU - Vaitkeviciene, G.
AU - Vettenranta, K.
AU - Åsberg, A.
AU - Frandsen, T. L.
AU - Opdahl, S.
AU - Marquart, H. V.
AU - Siitonen, S.
AU - Osnes, L. T.
AU - Hultdin, M.
AU - Overgaard, U. M.
AU - Wartiovaara-Kautto, U.
AU - Schmiegelow, K.
PY - 2020
Y1 - 2020
N2 - The NOPHO ALL2008 is a population-based study using an unmodified pediatric protocol in patients 1–45 years of age with acute lymphoblastic leukemia. Patients with T-ALL were given a traditional pediatric scheme if fast responding (minimal residual disease (MRD) < 0.1% day 29), or intensive block-based chemotherapy if slow responding (MRD > 0.1% day 29). Both treatment arms included pediatric doses of high-dose methotrexate and asparaginase. If MRD ≥ 5% on day 29 or ≥0.1% after consolidation, patients were assigned to allogeneic hematopoietic stem cell transplantation. The 5-year overall survival of the 278 T-ALL patients was 0.75 (95% CI 0.69–0.81), being 0.82 (0.74–0.88) for patients 1.0–9.9 years, 0.76 (0.66–0.86) for those 10.0–17.9 years, and 0.65 (0.55–0.75) for the older patients. The risk of death in first remission was significantly higher in adults (12%) compared with the 1–9 years group (4%). The MRD responses in the three age groups were similar, and only a nonsignificant increase in relapse risk was found in adults. In conclusion, an unmodified pediatric protocol in patients 1–45 years is effective in all age groups. The traditional pediatric treatment schedule was safe for all patients, but the intensive block therapy led to a high toxic death rate in adults.
AB - The NOPHO ALL2008 is a population-based study using an unmodified pediatric protocol in patients 1–45 years of age with acute lymphoblastic leukemia. Patients with T-ALL were given a traditional pediatric scheme if fast responding (minimal residual disease (MRD) < 0.1% day 29), or intensive block-based chemotherapy if slow responding (MRD > 0.1% day 29). Both treatment arms included pediatric doses of high-dose methotrexate and asparaginase. If MRD ≥ 5% on day 29 or ≥0.1% after consolidation, patients were assigned to allogeneic hematopoietic stem cell transplantation. The 5-year overall survival of the 278 T-ALL patients was 0.75 (95% CI 0.69–0.81), being 0.82 (0.74–0.88) for patients 1.0–9.9 years, 0.76 (0.66–0.86) for those 10.0–17.9 years, and 0.65 (0.55–0.75) for the older patients. The risk of death in first remission was significantly higher in adults (12%) compared with the 1–9 years group (4%). The MRD responses in the three age groups were similar, and only a nonsignificant increase in relapse risk was found in adults. In conclusion, an unmodified pediatric protocol in patients 1–45 years is effective in all age groups. The traditional pediatric treatment schedule was safe for all patients, but the intensive block therapy led to a high toxic death rate in adults.
U2 - 10.1038/s41375-019-0598-2
DO - 10.1038/s41375-019-0598-2
M3 - Journal article
C2 - 31611626
AN - SCOPUS:85076485737
VL - 34
SP - 347
EP - 357
JO - Leukemia
JF - Leukemia
SN - 0887-6924
IS - 2
ER -
ID: 236722616