Therapiestudie BFM 79/81 zur Behandlung der akuten lymphoblastischen Leukämie bei Kindern und Jugendlichen: intensivierte Reinduktionstherapie für Patientengruppen mit unterschiedlichem Rezidivrisiko

Adult acute lymphoblastic leukaemia: A study of prognostic features and response to treatment over a ten year period

“…Early intensive consolidation has been reported to improve survival in children (Henze et al, 1982;Lampert et al, 1984) and our own programme of DAT consolidation given early in remission was designed to achieve similar benefit in adults. In the event a minor improvement was observed in the actuarial survival with the more intensive regimen, but this was not significant.…”

“…Anaemia, thrombocytopenia, the absence of the common c-ALL antigen (CALLA) and the morphological FAB subtype L2 have also been shown to be associated with poor prognosis (Greaves et al, 1981;Sallan et al, 1980). The overall five year survival in children is 50% (Chessells et al, 1977;Hagbin et al, 1980) although some centres using more intensive protocols report better results (Henze et al, 1982;Lampert et al, 1984).…”

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

“…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.…”

“…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. [8][9][10] Vincristine/prednisone pulses in maintenance therapy had shown no significant benefit in SR patients in ALL-BFM 79 (randomized study) and were no longer used.…”

“…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.…”