High cure rate with a moderately intensive treatment regimen in non-high-risk childhood acute lymphoblastic leukemia. Results of protocol ALL VI from the Dutch Childhood Leukemia Study Group.

Abstract

der Does-Van den BergPurpose: Here we report the results of a nationwide cooperative study in the Netherlands on acute lymphoblastic leukemia (ALL) in children. The aim of the study w as to improve the cure rate and to minimize side effects in a group of no n -h igh -risk ALL patients, especially with regard to the CNS. A second aim w as to study potential prognostic factors.Methods: Children (age 0 to 15 years) with n o n -h ighrisk ALL (WBC count < 50 x 109/L, no mediastinal m ass, no B-cell phenotype, and no CNS involvement) were treated with a uniform protocol, ALL VI. The treatment protocol used 6-week induction regimen with three drugs (vincristine, dexamethasone, and asp aragin ase), three weekly doses of intravenous (IV) medium high-dose methotrexate (2 g/m 2), and 2-year maintenance therapy that consisted of alternating 5-w eek periods of metho trexate and mercaptopurine and 2-w eek periods of vin cristine and dexamethasone. In the first ye a r of mainte nance, triple intrathecal therapy w as administered every 7 weeks.Results: From December 1, 1984 until Ju ly 1, 1988,

Visuomotor control in survivors of childhood acute lymphoblastic leukemia treated with chemotherapy only

“…The children with ALL had been treated according to the consecutive Dutch Childhood Leukemia Study Group (DCLSG) ALL treatment protocols 6 to 9 (Kamps et al, , 2002Veerman et al, 1996), and were diagnosed between 1985 and 1999. Patients were stratified into risk groups based on leukemia cell load, cell phenotype and spread of the disease.…”

“…The criteria for risk group classification varied across the different protocols. In our study, 15 children had been treated according to the ALL standard treatment protocols and 19 according to intensified protocols, these numbers corresponding with the distribution of risk groups nationwide (Kamps et al, , 2002Veerman et al, 1996). CNSdirected treatment consisted of intrathecal chemotherapy and of systemically administered methotrexate and corticosteroids.…”

Long-term results of Dutch Childhood Oncology Group studies for children with acute lymphoblastic leukemia from 1984 to 2004

“…5,8,9,10 These are briefly described below and summarized in Figures 1a and b. Protocol ALL-6 opened to children with newly diagnosed ALL in the Netherlands diagnosed from December 1984 to July 1988.…”

“…Total duration of therapy was 116 weeks. 5 Protocol ALL-7 was open from July 1988 through September 1991 for all newly diagnosed de novo ALL patients who were 0 through 15 years of age. Chemotherapy and risk group stratification, based on tumor mass and early response to treatment into standard risk (SRG), risk (RG) and experimental group (EG), were similar to that of ALL-BFM-86, but cranial irradiation (18 Gy) after protocol II was restricted to patient's age X1 year with initial CNS involvement (±2% of all patients).…”

“…This ALL-6 study was eligible only to NHR patients, whereas high-risk (HR) patients were treated by the institutional pilot protocols. 4,5 In 1986, the DCLSG founded together with the GermanAustrian Berlin-Frankfurt-Mü nster (BFM) cooperative group and the Italian AIEOP cooperative group the international BFM study group (I-BFM-SG) and adopted the BFM backbone strategy in protocols DCSLG-ALL-7 and ALL-8, which ran from 1988 to 1991 and from 1991 to 1997, respectively. Also the BFM risk stratification criteria, based on initial day 8 prednisone response, tumor load (BFM risk factor) and cell biological characteristics, were adopted at that time.…”