Therapeutic trial for infant acute lymphoblastic leukemia: The Pediatric Oncology Group experience (POG 8493)

L. S. Frankel, J. Ochs, J. J. Shuster, R. Dubowy, W. P. Bowman, M. Hockenberry-Eaton, Michael J Borowitz, A. J. Carroll, C. P. Steuber, D. J. Pullen

Research output: Contribution to journalArticle

Abstract

Purpose: Despite improved event-free survival of older children with acute lymphocytic leukemia (ALL), infants 50,000/μl), and a higher likelihood of CD-10 (CALLA) negative lymphoblasts (55%). A translocation involving chromosome 11 at band q23 was detected in 27 of 64 cytogenetically informative cases. Treatment was based upon two institutional pilot studies utilizing chemotherapy doses based upon body weight. Important components included remission induction with cyclophosphamide (Ctx), vincristine (Vcr), cytosine arabinoside (Ara-C), and prednisone (Pred) (COAP); consolidation therapy with teniposide (VM-26) and Ara-C; and continuation therapy with alternating pulses of COAP with VM- 26/Ara-C separated by a methotrexate (Mtx) and 6-mercaptopurine (6-MP) backbone plus CNS therapy consisting of standard triple intrathecal therapy (TIT) (Mtx/hydrocortisone/Ara-C), which avoided the use of radiotherapy in this population. Results: Seventy-six infants achieved a complete remission (93%). Fifty patients have relapsed: 35 isolated marrow relapses, five isolated CNS relapses, eight combined marrow and CNS relapses, and two other relapses. Actuarial event-free survival was 28% (SE = 5%) at 4 years. Infants >274 days (9 months) at diagnosis had a better outcome than those

Original languageEnglish (US)
Pages (from-to)35-42
Number of pages8
JournalJournal of Pediatric Hematology/Oncology
Volume19
Issue number1
DOIs
StatePublished - 1997
Externally publishedYes

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Cytarabine
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Teniposide
Pediatrics
Recurrence
Methotrexate
Disease-Free Survival
Bone Marrow
Therapeutics
Remission Induction
6-Mercaptopurine
Chromosomes, Human, Pair 11
Vincristine
Prednisone
Cyclophosphamide
Hydrocortisone
Radiotherapy
Body Weight
Drug Therapy
Population

Keywords

  • Acute lymphocytic leukemia of childhood
  • Infant leukemia
  • Therapy of leukemia in infants

ASJC Scopus subject areas

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

Cite this

Frankel, L. S., Ochs, J., Shuster, J. J., Dubowy, R., Bowman, W. P., Hockenberry-Eaton, M., ... Pullen, D. J. (1997). Therapeutic trial for infant acute lymphoblastic leukemia: The Pediatric Oncology Group experience (POG 8493). Journal of Pediatric Hematology/Oncology, 19(1), 35-42. https://doi.org/10.1097/00043426-199701000-00005

Therapeutic trial for infant acute lymphoblastic leukemia : The Pediatric Oncology Group experience (POG 8493). / Frankel, L. S.; Ochs, J.; Shuster, J. J.; Dubowy, R.; Bowman, W. P.; Hockenberry-Eaton, M.; Borowitz, Michael J; Carroll, A. J.; Steuber, C. P.; Pullen, D. J.

In: Journal of Pediatric Hematology/Oncology, Vol. 19, No. 1, 1997, p. 35-42.

Research output: Contribution to journalArticle

Frankel, LS, Ochs, J, Shuster, JJ, Dubowy, R, Bowman, WP, Hockenberry-Eaton, M, Borowitz, MJ, Carroll, AJ, Steuber, CP & Pullen, DJ 1997, 'Therapeutic trial for infant acute lymphoblastic leukemia: The Pediatric Oncology Group experience (POG 8493)', Journal of Pediatric Hematology/Oncology, vol. 19, no. 1, pp. 35-42. https://doi.org/10.1097/00043426-199701000-00005
Frankel, L. S. ; Ochs, J. ; Shuster, J. J. ; Dubowy, R. ; Bowman, W. P. ; Hockenberry-Eaton, M. ; Borowitz, Michael J ; Carroll, A. J. ; Steuber, C. P. ; Pullen, D. J. / Therapeutic trial for infant acute lymphoblastic leukemia : The Pediatric Oncology Group experience (POG 8493). In: Journal of Pediatric Hematology/Oncology. 1997 ; Vol. 19, No. 1. pp. 35-42.
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AU - Dubowy, R.

AU - Bowman, W. P.

AU - Hockenberry-Eaton, M.

AU - Borowitz, Michael J

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AU - Pullen, D. J.

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