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

Abstract

The trial ALL-BFM 95 for treatment of childhood acute lymphoblastic leukemia was designed to reduce acute and longterm 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.

Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

“…Male to female ratio of 1.5 and hyperleukocytosis as documented in 21.6% of patients were also comparable to that of the same study. The proportion of patients in our series with T-ALL (13.5%) was comparable to figures reported from studies worldwide including the BFM 95 study (13.3%) [8]. This percentage was also comparable to 13.9%-17.4% of children with T-ALL reported in the last five studies at St Jude Children's Research Hospital [19].…”

“…The median age was 5.4 years compared with 5.0 years in the ALL-BFM 95 study [8]. Male to female ratio of 1.5 and hyperleukocytosis as documented in 21.6% of patients were also comparable to that of the same study.…”

“…In many HICs, the cure rate of childhood ALL has exceeded 80% [4][5][6][7][8]. However, 80-85% of the cases of childhood ALL occur in resource-poor countries where the cure rate is significantly lower than that of resource-rich countries.…”

“…Today, the overall cure rate of ALL is 80% in resource-rich countries [4][5][6][7][8]. In low-income countries (LICs), however, therapy results for pediatric ALL are still not encouraging.…”

Leukemia-associated genetic aberrations in mesenchymal stem cells of children with acute lymphoblastic leukemia

“…The BCR-ABL1 fusion gene generates a benign or chronic myeloproliferative clonal expansion in both transgenic mice and adult patients (17). INTRODUCTION 14 the ALL-BFM (Berlin-Frankfurt-Münster) /Co-ALL-07-03 study protocols for initial ALL (31,32) or ALL-REZ-BFM study protocol for relapsed ALL (33)(34)(35) treatment protocol is given in Figure 3. Kindly provided from Prof. Henze.…”