PMID- 17179108
OWN - NLM
STAT- MEDLINE
DCOM- 20070108
LR  - 20071115
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Linking)
VI  - 24
IP  - 36
DP  - 2006 Dec 20
TI  - Superiority of allogeneic hematopoietic stem-cell transplantation compared with 
      chemotherapy alone in high-risk childhood T-cell acute lymphoblastic leukemia: 
      results from ALL-BFM 90 and 95.
PG  - 5742-9
AB  - PURPOSE: The role of hematopoietic stem-cell transplantation (SCT) in first 
      complete remission (CR1) for children with very high-risk (VHR) acute 
      lymphoblastic leukemia (ALL) is still under critical discussion. PATIENTS AND 
      METHODS: In the ALL-Berlin-Frankfurt-Munster (BFM) 90 and ALL-BFM 95 trials, 387 
      patients were eligible for SCT if there was a matched sibling donor (MSD). T-cell 
      ALL (T-ALL) patients with poor in vivo response to initial treatment represented 
      the largest homogeneous subgroup within VHR patients. RESULTS: Of 191 high-risk 
      (HR) T-ALL patients, 179 patients (94%) achieved CR1. Twenty-three patients 
      received an MSD-SCT. Furthermore, in trial ALL-BFM 95, eight matched unrelated 
      donors (MUDs) and five mismatched family donors (MMFDs) were used. The median 
      time to SCT was 5 months (range, 2.4 to 10.8 months) from diagnosis. The 5-year 
      disease-free survival (DFS) was 67% +/- 8% for 36 patients who received an SCT in 
      CR1 and 42% +/- 5% for the 120 patients treated with chemotherapy alone having an 
      event-free survival time of at least the median time to transplantation 
      (Mantel-Byar, P = .01). Overall survival (OS) rate for the SCT group was 67% +/- 
      8% at 5 years, whereas patients treated with chemotherapy alone had an OS rate of 
      47% +/- 5% at 5 years (Mantel-Byar, P = .01). Outcome of patients who received 
      MSD-SCT versus MUD-/MMFD-SCT was comparable (DFS, 65% +/- 10% v 69% +/- 13%, 
      respectively). However, relapses only occurred after MSD-SCT (eight of 23 
      patients), whereas treatment-related mortality only occurred after MUD-/MMFD-SCT 
      (four of 13 patients). CONCLUSION: SCT in CR1 is superior to treatment with 
      chemotherapy alone for childhood HR-T-ALL.
FAU - Schrauder, Andre
AU  - Schrauder A
AD  - Department of Pediatrics, University Medical Center Schleswig-Holstein, Campus 
      Kiel, Kiel, Germany.
FAU - Reiter, Alfred
AU  - Reiter A
FAU - Gadner, Helmut
AU  - Gadner H
FAU - Niethammer, Dietrich
AU  - Niethammer D
FAU - Klingebiel, Thomas
AU  - Klingebiel T
FAU - Kremens, Bernhard
AU  - Kremens B
FAU - Peters, Christina
AU  - Peters C
FAU - Ebell, Wolfram
AU  - Ebell W
FAU - Zimmermann, Martin
AU  - Zimmermann M
FAU - Niggli, Felix
AU  - Niggli F
FAU - Ludwig, Wolf-Dieter
AU  - Ludwig WD
FAU - Riehm, Hansjorg
AU  - Riehm H
FAU - Welte, Karl
AU  - Welte K
FAU - Schrappe, Martin
AU  - Schrappe M
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
MH  - Adolescent
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Disease-Free Survival
MH  - Female
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Histocompatibility Testing
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Leukemia-Lymphoma, Adult T-Cell/*drug therapy
MH  - Male
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy
MH  - Risk Factors
MH  - Transplantation, Homologous
EDAT- 2006/12/21 09:00
MHDA- 2007/01/09 09:00
CRDT- 2006/12/21 09:00
PHST- 2006/12/21 09:00 [pubmed]
PHST- 2007/01/09 09:00 [medline]
PHST- 2006/12/21 09:00 [entrez]
AID - 24/36/5742 [pii]
AID - 10.1200/JCO.2006.06.2679 [doi]
PST - ppublish
SO  - J Clin Oncol. 2006 Dec 20;24(36):5742-9. doi: 10.1200/JCO.2006.06.2679.