Outcome of Children with Standard-Risk T-Lineage Acute Lymphoblastic Leukemia—Comparison among Different Treatment Strategies

Yousif Matloub, Linda Stork, Barbara Asselin, Stephen P. Hunger, Michael J Borowitz, Tamekia Jones, Bruce Bostrom, Julie M. Gastier-Foster, Nyla A. Heerema, Andrew Carroll, Naomi Winick, William L. Carroll, Bruce Camitta, Meenakshi Devidas, Paul S. Gaynon

Research output: Contribution to journalArticle

Abstract

Background: Children with T-lineage acute lymphoblastic leukemia ALL (T-ALL) historically have had inferior outcomes compared with the children with precursor-B ALL (B-ALL). After 1995, the Children's Cancer Group (CCG) treated patients with B- and T-ALL according to the National Cancer Institute (NCI) risk criteria, basing risk stratification on age and white blood cell (WBC) count regardless of immunophenotype. The Pediatric Oncology Group (POG) treated all the patients with T-ALL on separate, generally more intensive protocols than those used to treat the patients with B-ALL. Procedure: We compared the outcomes of children with T-ALL and NCI standard-risk (SR) criteria treated on CCG and POG trials between 1996 and 2005. CCG SR-ALL 1952 and 1991 enrolled 80 and 86 patients with T-ALL, respectively, utilizing a reduced intensity Berlin–Frankfurt–Münster backbone. Treatment was intensified for slow early responders and only patients with overt central nervous system leukemia received cranial irradiation. Eighty-four patients with T-ALL and SR features were enrolled on POG 9404 comprising more intensive therapy with all patients receiving cranial irradiation. Results: The 7-year event-free survival (EFS) for patients with SR T-ALL on CCG 1952, CCG 1991, and POG 9404 were 74.1 ± 5.8%, 81.8 ± 5.3%, and 84.2 ± 4.3%, respectively (P = 0.18). Overall 7-year survivals were 86.1 ± 4.6%, 88.3 ± 4.4%, 89.1 ± 3.6%, respectively (P = 0.84). Conclusions: Comparable high rates of EFS and long-term survival were achieved with all three regimens, with the CCG regimens utilizing a less intensive chemotherapy backbone without prophylactic cranial irradiation for patients with SR T-ALL.

Original languageEnglish (US)
Pages (from-to)255-261
Number of pages7
JournalPediatric Blood and Cancer
Volume63
Issue number2
DOIs
StatePublished - Feb 1 2016

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Cranial Irradiation
Pediatrics
Neoplasms
Therapeutics
National Cancer Institute (U.S.)
Disease-Free Survival
Survival
Leukocyte Count
Leukemia
Central Nervous System
Drug Therapy

Keywords

  • childhood acute leukemia
  • childhood leukemia
  • T-cell leukemia

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Outcome of Children with Standard-Risk T-Lineage Acute Lymphoblastic Leukemia—Comparison among Different Treatment Strategies. / Matloub, Yousif; Stork, Linda; Asselin, Barbara; Hunger, Stephen P.; Borowitz, Michael J; Jones, Tamekia; Bostrom, Bruce; Gastier-Foster, Julie M.; Heerema, Nyla A.; Carroll, Andrew; Winick, Naomi; Carroll, William L.; Camitta, Bruce; Devidas, Meenakshi; Gaynon, Paul S.

In: Pediatric Blood and Cancer, Vol. 63, No. 2, 01.02.2016, p. 255-261.

Research output: Contribution to journalArticle

Matloub, Y, Stork, L, Asselin, B, Hunger, SP, Borowitz, MJ, Jones, T, Bostrom, B, Gastier-Foster, JM, Heerema, NA, Carroll, A, Winick, N, Carroll, WL, Camitta, B, Devidas, M & Gaynon, PS 2016, 'Outcome of Children with Standard-Risk T-Lineage Acute Lymphoblastic Leukemia—Comparison among Different Treatment Strategies', Pediatric Blood and Cancer, vol. 63, no. 2, pp. 255-261. https://doi.org/10.1002/pbc.25793
Matloub, Yousif ; Stork, Linda ; Asselin, Barbara ; Hunger, Stephen P. ; Borowitz, Michael J ; Jones, Tamekia ; Bostrom, Bruce ; Gastier-Foster, Julie M. ; Heerema, Nyla A. ; Carroll, Andrew ; Winick, Naomi ; Carroll, William L. ; Camitta, Bruce ; Devidas, Meenakshi ; Gaynon, Paul S. / Outcome of Children with Standard-Risk T-Lineage Acute Lymphoblastic Leukemia—Comparison among Different Treatment Strategies. In: Pediatric Blood and Cancer. 2016 ; Vol. 63, No. 2. pp. 255-261.
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abstract = "Background: Children with T-lineage acute lymphoblastic leukemia ALL (T-ALL) historically have had inferior outcomes compared with the children with precursor-B ALL (B-ALL). After 1995, the Children's Cancer Group (CCG) treated patients with B- and T-ALL according to the National Cancer Institute (NCI) risk criteria, basing risk stratification on age and white blood cell (WBC) count regardless of immunophenotype. The Pediatric Oncology Group (POG) treated all the patients with T-ALL on separate, generally more intensive protocols than those used to treat the patients with B-ALL. Procedure: We compared the outcomes of children with T-ALL and NCI standard-risk (SR) criteria treated on CCG and POG trials between 1996 and 2005. CCG SR-ALL 1952 and 1991 enrolled 80 and 86 patients with T-ALL, respectively, utilizing a reduced intensity Berlin–Frankfurt–M{\"u}nster backbone. Treatment was intensified for slow early responders and only patients with overt central nervous system leukemia received cranial irradiation. Eighty-four patients with T-ALL and SR features were enrolled on POG 9404 comprising more intensive therapy with all patients receiving cranial irradiation. Results: The 7-year event-free survival (EFS) for patients with SR T-ALL on CCG 1952, CCG 1991, and POG 9404 were 74.1 ± 5.8{\%}, 81.8 ± 5.3{\%}, and 84.2 ± 4.3{\%}, respectively (P = 0.18). Overall 7-year survivals were 86.1 ± 4.6{\%}, 88.3 ± 4.4{\%}, 89.1 ± 3.6{\%}, respectively (P = 0.84). Conclusions: Comparable high rates of EFS and long-term survival were achieved with all three regimens, with the CCG regimens utilizing a less intensive chemotherapy backbone without prophylactic cranial irradiation for patients with SR T-ALL.",
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AU - Asselin, Barbara

AU - Hunger, Stephen P.

AU - Borowitz, Michael J

AU - Jones, Tamekia

AU - Bostrom, Bruce

AU - Gastier-Foster, Julie M.

AU - Heerema, Nyla A.

AU - Carroll, Andrew

AU - Winick, Naomi

AU - Carroll, William L.

AU - Camitta, Bruce

AU - Devidas, Meenakshi

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N2 - Background: Children with T-lineage acute lymphoblastic leukemia ALL (T-ALL) historically have had inferior outcomes compared with the children with precursor-B ALL (B-ALL). After 1995, the Children's Cancer Group (CCG) treated patients with B- and T-ALL according to the National Cancer Institute (NCI) risk criteria, basing risk stratification on age and white blood cell (WBC) count regardless of immunophenotype. The Pediatric Oncology Group (POG) treated all the patients with T-ALL on separate, generally more intensive protocols than those used to treat the patients with B-ALL. Procedure: We compared the outcomes of children with T-ALL and NCI standard-risk (SR) criteria treated on CCG and POG trials between 1996 and 2005. CCG SR-ALL 1952 and 1991 enrolled 80 and 86 patients with T-ALL, respectively, utilizing a reduced intensity Berlin–Frankfurt–Münster backbone. Treatment was intensified for slow early responders and only patients with overt central nervous system leukemia received cranial irradiation. Eighty-four patients with T-ALL and SR features were enrolled on POG 9404 comprising more intensive therapy with all patients receiving cranial irradiation. Results: The 7-year event-free survival (EFS) for patients with SR T-ALL on CCG 1952, CCG 1991, and POG 9404 were 74.1 ± 5.8%, 81.8 ± 5.3%, and 84.2 ± 4.3%, respectively (P = 0.18). Overall 7-year survivals were 86.1 ± 4.6%, 88.3 ± 4.4%, 89.1 ± 3.6%, respectively (P = 0.84). Conclusions: Comparable high rates of EFS and long-term survival were achieved with all three regimens, with the CCG regimens utilizing a less intensive chemotherapy backbone without prophylactic cranial irradiation for patients with SR T-ALL.

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