Document Detail


Analysis of the role of hematopoietic stem-cell transplantation in infants with acute lymphoblastic leukemia in first remission and MLL gene rearrangements: a report from the Children's Oncology Group.
MedLine Citation:
PMID:  21135279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Although the majority of children with acute lymphoblastic leukemia (ALL) are cured with current therapy, the event-free survival (EFS) of infants with ALL, particularly those with mixed lineage leukemia (MLL) gene rearrangements, is only 30% to 40%. Relapse has been the major source of treatment failure for these patients. The parallel Children's Cancer Group (CCG) 1953 and Pediatric Oncology Group (POG) 9407 studies were designed to test the hypothesis that more intensive therapy, including dose intensification of chemotherapy, and hematopoietic stem-cell transplantation (HSCT) would improve the outcome for this group of patients.
PATIENTS AND METHODS: One hundred eighty-nine infants (CCG 1953, n = 115; POG 9407, n = 74) were enrolled between October 1996 and August 2000. For infants with the MLL gene rearrangement and an appropriate donor, HSCT was the preferred treatment on CCG 1953 and investigator option on POG 9407 after completion of the second phase of therapy. Fifty-three infants underwent HSCT.
RESULTS: The 5-year EFS rate was 48.8% (95% CI, 33.9% to 63.7%) in patients who received HSCT and 48.7% (95% CI, 33.8% to 63.6%) in patients treated with chemotherapy alone (P = .60). Transplantation outcomes were not affected by the preparatory regimen or donor source.
CONCLUSION: Our data suggest that routine use of HSCT for infants with MLL-rearranged ALL is not indicated. However, limited by small numbers, this study should not be considered the definitive answer to this question.
Authors:
ZoAnn E Dreyer; Patricia A Dinndorf; Bruce Camitta; Harland Sather; Mei K La; Meenakshi Devidas; Joanne M Hilden; Nyla A Heerema; Jean E Sanders; Ron McGlennen; Cheryl L Willman; Andrew J Carroll; Fred Behm; Franklin O Smith; William G Woods; Kamar Godder; Gregory H Reaman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-12-06
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  29     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-07     Completed Date:  2011-02-22     Revised Date:  2014-06-16    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  214-22     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Chromosome Aberrations
Disease-Free Survival
Gene Order*
Hematopoietic Stem Cell Transplantation*
Humans
Infant
Myeloid-Lymphoid Leukemia Protein / genetics*
Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*,  surgery*
Remission Induction
Treatment Outcome
Grant Support
ID/Acronym/Agency:
U10 CA098543/CA/NCI NIH HHS; U10 CA98413/CA/NCI NIH HHS; U10 CA98543/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/MLL protein, human; 149025-06-9/Myeloid-Lymphoid Leukemia Protein
Comments/Corrections

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