PMID- 18711187
OWN - NLM
STAT- MEDLINE
DCOM- 20080902
LR  - 20211020
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 26
IP  - 24
DP  - 2008 Aug 20
TI  - Reinduction platform for children with first marrow relapse of acute 
      lymphoblastic Leukemia: A Children's Oncology Group Study[corrected].
PG  - 3971-8
LID - 10.1200/JCO.2008.16.1414 [doi]
AB  - PURPOSE: Treatment of childhood relapsed acute lymphoblastic leukemia (ALL) 
      remains a significant challenge. The goal of the Children's Oncology Group (COG) 
      AALL01P2 study was to develop a safe and active chemotherapy reinduction 
      platform, which could be used to evaluate novel agents in future trials. PATIENTS 
      AND METHODS: One hundred twenty-four patients with ALL and first marrow relapse 
      received three, 35-day blocks of reinduction chemotherapy: 69 with early relapse 
      (ER; < 36 months from initial diagnosis) and 55 with late relapse (LR). Minimal 
      residual disease (MRD) was measured by flow cytometry after each treatment block. 
      RESULTS: Second complete remission (CR2) rates at the end of block 1 in 117 
      assessable patients were 68% +/- 6% for ER (n = 63) and 96% +/- 3% for LR (n = 
      54; P < .0001). Five of seven patients with T-cell ALL (T-ALL) failed to achieve 
      CR2. Among patients in CR2, MRD greater than 0.01% was detected at the end of 
      block 1 in 75% +/- 7% of ER (n = 36) versus 51% +/- 8% of LR (n = 43; P = .0375) 
      and 12-month event-free survival was 80% +/- 7% versus 58% +/- 7% in MRD-negative 
      versus positive patients (P < .0005). Blocks 2 and 3 of therapy resulted in 
      reduction of MRD burden in 40 of 56 patients who were MRD positive after block 1. 
      Toxicity was acceptable during all three blocks with five deaths (4%) from 
      infections. CONCLUSION: The AALL01P2 regimen is a tolerable and active 
      reinduction platform, suitable for testing in combination with novel agents in 
      B-precursor ALL. Alternative strategies are needed for T-ALL. Serial MRD 
      measurements were feasible and prognostic of outcome.
FAU - Raetz, Elizabeth A
AU  - Raetz EA
AD  - New York University School of Medicine, Hassenfeld Children's Center for Cancer 
      and Blood Disorders, 160 E 32nd St, New York, NY 10016, USA. 
      elizabeth.raetz@nyumc.org
FAU - Borowitz, Michael J
AU  - Borowitz MJ
FAU - Devidas, Meenakshi
AU  - Devidas M
FAU - Linda, Stephen B
AU  - Linda SB
FAU - Hunger, Stephen P
AU  - Hunger SP
FAU - Winick, Naomi J
AU  - Winick NJ
FAU - Camitta, Bruce M
AU  - Camitta BM
FAU - Gaynon, Paul S
AU  - Gaynon PS
FAU - Carroll, William L
AU  - Carroll WL
LA  - eng
GR  - R21CA110344/CA/NCI NIH HHS/United States
GR  - U10 CA98543/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 04079A1RDZ (Cytarabine)
RN  - 7S5I7G3JQL (Dexamethasone)
RN  - 80168379AG (Doxorubicin)
RN  - VB0R961HZT (Prednisone)
RN  - ZRP63D75JW (Idarubicin)
SB  - IM
EIN - J Clin Oncol. 2008 Oct 1;26(28): 4697.
MH  - Adolescent
MH  - Adult
MH  - Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/adverse 
      effects
MH  - Bone Marrow Neoplasms/*drug therapy/pathology
MH  - Central Nervous System Neoplasms/drug therapy/pathology
MH  - Child
MH  - Child, Preschool
MH  - Cytarabine/administration & dosage/adverse effects
MH  - Dexamethasone/administration & dosage/adverse effects
MH  - Doxorubicin/administration & dosage/adverse effects
MH  - Female
MH  - Flow Cytometry
MH  - Humans
MH  - Idarubicin/administration & dosage/adverse effects
MH  - Infant
MH  - Leukemia, T-Cell/drug therapy/pathology
MH  - Leukemic Infiltration
MH  - Male
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy/pathology
MH  - Prednisone/administration & dosage/adverse effects
MH  - Remission Induction
PMC - PMC2654313
EDAT- 2008/08/20 09:00
MHDA- 2008/09/03 09:00
PMCR- 2009/08/20
CRDT- 2008/08/20 09:00
PHST- 2008/08/20 09:00 [pubmed]
PHST- 2008/09/03 09:00 [medline]
PHST- 2008/08/20 09:00 [entrez]
PHST- 2009/08/20 00:00 [pmc-release]
AID - 26/24/3971 [pii]
AID - 61414 [pii]
AID - 10.1200/JCO.2008.16.1414 [doi]
PST - ppublish
SO  - J Clin Oncol. 2008 Aug 20;26(24):3971-8. doi: 10.1200/JCO.2008.16.1414.