Document Detail

Outcome of childhood acute lymphoblastic leukemia with induction failure treated by the Japan Association of Childhood Leukemia study (JACLS) ALL F-protocol.
MedLine Citation:
PMID:  19813250     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Children with acute lymphoblastic leukemia (ALL) who fail to achieve complete remission (CR) after induction therapy (induction failure: IF) have a poor prognosis; however, there have been few prospective studies in patients with IF. PATIENTS AND METHODS: Between April 1997 and March 2005, 27 of 1,237 leukemic patients (2.2%) failed to achieve CR after four- or five-drug induction therapy. Twenty-three of these patients entered the F-protocol study, which mainly consisted of acute-myeloid-leukemia-oriented chemotherapy followed by scheduled hematopoietic cell transplantation (HCT). RESULTS: Seventeen (73.9%) of the 23 patients responded to re-induction chemotherapy with CR. Of note, 15 (93.8%) of 16 patients with Philadelphia-chromosome-negative (non-Ph(+)) ALL achieved CR; in contrast, only 2 (28.6%) of 7 Ph(+) patients achieved CR. Fourteen (82.4%) of 17 patients remained in CR (CCR) until their scheduled HCT, 12 of the 14 with CCR underwent HCT as scheduled, and 6 patients remain in first CR after a median of 78 months (range, 49-107 months). The 5-year overall survival (OS) rates of 16 patients with non-Ph(+) and 7 patients with Ph(+) were 43.8 +/- 12.4% and 14.3 +/- 13.2%, respectively (P = 0.012). The 5-year OS rate of the 17 patients who obtained CR by re-induction therapy and the 6 who did not were 47.1 +/- 12.1% and 0%, respectively (P < 0.001). CONCLUSION: Acute-myeloid-leukemia-oriented chemotherapy followed by scheduled HCT is a promising treatment strategy for non-Ph(+) ALL patients with IF.
Nobuhiro Suzuki; Keiko Yumura-Yagi; Makoto Yoshida; Junichi Hara; Shinichiro Nishimura; Tooru Kudoh; Akio Tawa; Ikuya Usami; Akihiko Tanizawa; Hiroki Hori; Yasuhiko Ito; Ryosuke Miyaji; Megumi Oda; Koji Kato; Kazuko Hamamoto; Yuko Osugi; Yoshiko Hashii; Tatsutoshi Nakahata; Keizo Horibe;
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  54     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-11-17     Completed Date:  2009-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  71-8     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Wiley-Liss, Inc.
Department of Pediatrics, Sapporo Medical University Hospital, Sapporo, Japan.
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MeSH Terms
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Bone Marrow Transplantation*
Child, Preschool
Combined Modality Therapy
Philadelphia Chromosome
Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology,  therapy*
Prospective Studies
Remission Induction
Survival Rate
Treatment Outcome

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