Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: treatment results of 2169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95. Schrappe, M., Moricke, A., Reiter, A., Zimmermann, M., Gadner, H., Stanulla, M., Dordelmann, M., Loning, L., Beier, R., Ludwig, W., D., Ratei, R., Harbott, J., Boos, J., Mann, G., Niggli, F., Feldges, A., Henze, G., Welte, K., Beck, J., D., Klingebiel, T., Niemeyer, C., Zintl, F., Bode, U., Urban, C., Wehinger, H., Niethammer, D., Riehm, H., & Stu, G., A., S., A., L., L., B., F., M. Blood, 111(9):4477-4489, 2008.
Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: treatment results of 2169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95 [link]Website  abstract   bibtex   
The trial ALL-BFM 95 for treatment of childhood acute lymphoblastic leukemia was designed to reduce acute and long-term toxicity in selected patient groups with favorable prognosis and to improve outcome in poor-risk groups by treatment intensification. These aims were pursued through a stratification strategy using white blood cell count, age, immunophenotype, treatment response, and unfavorable genetic aberrations providing an excellent discrimination of risk groups. Estimated 6-year event-free survival (6y-pEFS) for all 2169 patients was 79.6% (+/- 0.9%). The large standard-risk (SR) group (35% of patients) achieved an excellent 6y-EFS of 89.5% (+/- 1.1%) despite significant reduction of anthracyclines. In the medium-risk (MR) group (53% of patients), 6y-pEFS was 79.7% (+/- 1.2%); no improvement was accomplished by the randomized use of additional intermediate-dose cytarabine after consolidation. Omission of preventive cranial irradiation in non-T-ALL MR patients was possible without significant reduction of EFS, although the incidence of central nervous system relapses increased. In the high-risk (HR) group (12% of patients), intensification of consolidation/reinduction treatment led to considerable improvement over the previous ALL-BFM trials yielding a 6y-pEFS of 49.2% (+/- 3.2%). Compared without previous trial ALL-BFM 90, consistently favorable results in non-HR patients were achieved with significant treatment reduction in the majority of these patients.
@article{
 title = {Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: treatment results of 2169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95},
 type = {article},
 year = {2008},
 identifiers = {[object Object]},
 keywords = {brain-tumors,childrens-cancer-group,clinical-significance,cranial irradiation,dana-farber,medical-research-council,multicenter randomized-trial,oncology-group,phase-iii,term follow-up},
 pages = {4477-4489},
 volume = {111},
 websites = {<Go to ISI>://000255387400015},
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 notes = {<m:note>294EO<m:linebreak/>Times Cited:85<m:linebreak/>Cited References Count:74</m:note>},
 abstract = {The trial ALL-BFM 95 for treatment of childhood acute lymphoblastic leukemia was designed to reduce acute and long-term toxicity in selected patient groups with favorable prognosis and to improve outcome in poor-risk groups by treatment intensification. These aims were pursued through a stratification strategy using white blood cell count, age, immunophenotype, treatment response, and unfavorable genetic aberrations providing an excellent discrimination of risk groups. Estimated 6-year event-free survival (6y-pEFS) for all 2169 patients was 79.6% (+/- 0.9%). The large standard-risk (SR) group (35% of patients) achieved an excellent 6y-EFS of 89.5% (+/- 1.1%) despite significant reduction of anthracyclines. In the medium-risk (MR) group (53% of patients), 6y-pEFS was 79.7% (+/- 1.2%); no improvement was accomplished by the randomized use of additional intermediate-dose cytarabine after consolidation. Omission of preventive cranial irradiation in non-T-ALL MR patients was possible without significant reduction of EFS, although the incidence of central nervous system relapses increased. In the high-risk (HR) group (12% of patients), intensification of consolidation/reinduction treatment led to considerable improvement over the previous ALL-BFM trials yielding a 6y-pEFS of 49.2% (+/- 3.2%). Compared without previous trial ALL-BFM 90, consistently favorable results in non-HR patients were achieved with significant treatment reduction in the majority of these patients.},
 bibtype = {article},
 author = {Schrappe, M and Moricke, A and Reiter, A and Zimmermann, M and Gadner, H and Stanulla, M and Dordelmann, M and Loning, L and Beier, R and Ludwig, W D and Ratei, R and Harbott, J and Boos, J and Mann, G and Niggli, F and Feldges, A and Henze, G and Welte, K and Beck, J D and Klingebiel, T and Niemeyer, C and Zintl, F and Bode, U and Urban, C and Wehinger, H and Niethammer, D and Riehm, H and Stu, German Austrian Swill A L L B F M},
 journal = {Blood},
 number = {9}
}

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