Ergebnisse der Studie BFM 76/79 zur Behandlung der akuten lymphoblastischen Leukämie bei Kindern und Jugendlichen*

Henze, Guenter; Langermann, H.-J.; Brämswig, J. H.; Breu, H; Gadner, Helmut; Schellong, G.; Weite, K.; Riehm, H

doi:10.1055/s-2008-1034450

Cited by 125 publications

(44 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The five trials have a common basic backbone derived from the previous BFM concept. 2,[4][5][6] The most relevant modifications are pointed out as follows: Figure 1 Treatment outlines of studies ALL-BFM 81-95. *Protocol was amended 2 years after start of study ALL-BFM 86: re-intensification (Protocol II) was introduced for the SRG and maintenance treatment was extended to 24 months for all risk groups.…”

Section: Treatmentmentioning

confidence: 99%

“…In induction, prednisone has been applied at a daily dose of 2.5 mg/kg or 60 mg/m 2 for 28 days (followed by a tapering-down phase) since trial ALL-BFM 70. 2,4,5,13 Beginning with trial ALL-BFM 83, induction therapy was started with a 1-week prednisone window to evaluate the in vivo response to treatment, and to avoid morbidity from tumor lysis syndrome a stepwise increase to full dose was allowed. 14 DEXA has been used for re-intensification for 2 weeks (plus tapering down) in Protocol III at 10 mg/m 2 /day (in trial ALL-BFM 70-79 with 15 mg/m 2 /day), for 4 weeks (plus tapering down) in Protocol II of studies ALL-BFM 81 and 83, and for 3 weeks in Protocol II in studies ALL-BFM 86, 90 and 95.…”

Section: Treatmentmentioning

confidence: 99%

“…The regimen also comprised cranial or craniospinal irradiation followed by antimetabolite-based maintenance therapy. In study ALL-BFM 76, introduction of the re-intensification element 'Protocol II' (which was basically a repetition of the induction element) for all high-risk (HR) patients significantly improved the outcome for these patients, 4 leading to implementation of a re-intensification element ('Protocol III') in trial ALL-BFM 79 also for standard-risk (SR) patients. [5][6][7] The concept of delayed intensification was probably one of the most significant contributions to all antileukemic regimens for ALL worldwide.…”

Section: Introductionmentioning

confidence: 99%

“…15 Trial ALL-BFM 90 aimed at further reduction of treatment burden for the majority of patients while selectively targeting subgroups with increased risk for treatment failure. Study objectives aimed for a reduction of long-term morbidity by (1) limiting pCRT to medium (MR) and HR patients using a dose of 12 Gy 16 and (2) by using less anthracyclines in induction in all patients; 17 on the other hand, further improvement in outcome was attempted by (3) using higher dose intensity in induction (by combining more drugs in a shorter period of time), (4) by additional use of L-asparaginase (L-ASP) in consolidation (randomization in MR patients) and (5) by treatment of HR patients after induction with short rotating pulses of intensive chemotherapy derived from the BFM relapse strategy. 18 In HR patients, treatment-related morbidity was investigated in a randomized phase-III study of r-metHuG-CSF.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000

Möricke¹,

Zimmermann

Reiter³

et al. 2009

Leukemia

470

303

View full text Add to dashboard Cite

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000

Möricke¹,

Zimmermann

Reiter³

et al. 2009

Leukemia

470

303

View full text Add to dashboard Cite

“…After careful considerations, protocol ALL-MB 91 was designed based on data from international trials, including the German ALL-BFM 76/79, 81/83 and 86 trials, [5][6][7][8] the Dutch DCLSG ALL-5 and ALL-6 trials 9,10 and the Dana-Farber consortium trials DFCI 81-01 and 85-01. [11][12][13] General aims were to use combination chemotherapy aiming at avoiding deep and long-lasting periods of bone marrow aplasia, thereby reducing the needs for extensive supportive care, the frequency of blood transfusions, long-lasting hospitalization and also costs.…”

Section: Introductionmentioning

confidence: 99%

Results of the first randomized multicentre trial on childhood acute lymphoblastic leukaemia in Russia

et al. 2008

View full text Add to dashboard Cite

Until 1990, the survival of children with acute lymphoblastic leukaemia (ALL) in Russia was below 10%. To establish a protocol feasible under conditions there, ALL-MB 91 was designed to avoid prolonged bone marrow aplasia, thereby reducing needs for extensive supportive care, blood transfusions, long-lasting hospitalization and costs. High-dose therapies were avoided, anthracycline use was limited and CNS radiation therapy only foreseen in high-risk patients (about 30%). This was randomized against a modified BFM protocol. From 1995 to 2002, 834 patients of age up to 18 years were registered in 10 centres and 713 received after central randomization the allocated risk-stratified treatment. After a median follow-up of 7 years, the event-free survival (EFS) was 67 ± 3% on ALL-MB 91 (N ¼ 358) vs 68 ± 3% on ALL-BFM 90m (N ¼ 355). The overall survival (OS) was 71±3% vs 74±2%, respectively. Anaemia, thrombocytopenia, agranulocytosis 410 days and hospitalization (median 35 vs 68 days) were lower on ALL-MB 91 (Po0.01, N ¼ 197). While EFS and OS were similar with both protocols, ALL-MB 91 significantly incurred fewer toxicity and resource requirements and, therefore, has been increasingly used across Russia.

show abstract

Lymphomatous presentation of childhood acute lymphoblastic leukemia. A subgroup at high risk of early treatment failure

Steinherz

Siegel

Bleyer

et al. 1991

Cancer

View full text Add to dashboard Cite

Multivariate analyses of the clinical course of 1537 children with acute lymphoblastic leukemia (ALL) identified a subgroup which experienced short remission duration and a high incidence of extramedullary relapse. The patients differed from other ALL patients by the presence at diagnosis of two or more of a constellation of clinical and laboratory features: organomegaly or mass disease, E-rosette positivity, hemoglobin level greater than 10 g/dl, leukocyte count greater than 50,000/microliters, male predominance, and older age. This type of presentation of ALL is referred to as the "lymphoma syndrome" (LS) since such patients exhibit a pattern of several clinical and laboratory features which were observed repeatedly but in differing combinations, and some of which clinically resemble lymphoma. A subsequent database from 2231 patients was analyzed. Patients with a mediastinal mass, massive splenomegaly, or massive adenopathy, alone or in combination, had a worse outcome when the patient also had either leukocytosis, E-rosette-positive lymphoblasts, or a normal or near normal hemoglobin (Hb) level at diagnosis. Similarly, the above three laboratory features alone or in combination did not predict less than 40% disease-free survival (DFS) unless they were accompanied by at least one of the clinical features of mass disease. When at least one clinical feature and at least one laboratory feature were present, the overall DFS was 36% 6 years after diagnosis versus 64% for all other patients. The association of these features with poor prognosis remained significant after adjusting for the level of leukocyte count at diagnosis, age at diagnosis, and sex of the patients. Patients with this recurrent syndrome of features do not represent a homogeneous biologic entity but they constitute a subgroup of patients with ALL having a high risk of treatment failure using current therapies, including failure to achieve remission, early relapse, and increased frequency of relapse in extramedullary sites. They deserve early recognition at diagnosis and selection of treatment strategies appropriate for very high risk ALL.

show abstract

Ergebnisse der Studie BFM 76/79 zur Behandlung der akuten lymphoblastischen Leukämie bei Kindern und Jugendlichen*

Cited by 125 publications

References 3 publications

Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000

Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000

Results of the first randomized multicentre trial on childhood acute lymphoblastic leukaemia in Russia

Lymphomatous presentation of childhood acute lymphoblastic leukemia. A subgroup at high risk of early treatment failure

Contact Info

Product

Resources

About