Acute lymphoblastic leukemia in children: Nonrandomized comparison of conventional vs. intensive chemotherapy at the National Cancer Institute of Colombia
✍ Scribed by Buendia, Maria Teresa Amparo; Terselich, Greti; Lozano, Juan Manuel; Viscaino, Marta Patricia
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 127 KB
- Volume
- 28
- Category
- Article
- ISSN
- 0098-1532
No coin nor oath required. For personal study only.
✦ Synopsis
Background:
This study aimed to compare the therapeutic efficacy of two treatments for childhood acute lymphoblastic leukemia (all), and to evaluate the feasibility of intensive chemotherapy in a developing country.
Methods:
The study was conducted at the national cancer institute in bogota, colombia. untreated all patients under 16 years of age were divided into two groups: a historical control cohort (hc) of 141 patients treated with conventional chemotherapy and an intensive chemotherapy cohort (ic) of 130 patients treated with a modified berlin-frankfurt-münster protocol (m-bfm). patients were clinically classified into risk categories for relapse, and followed through july 31, 1995. disease-free survival (dfs) curves were obtained using the kaplan-meier method and were compared by the log rank test.
Results:
Therapy groups had similar clinical baseline characteristics. nonresponse rate to induction was higher in the hc group (16.3%) than in the ic cohort (7.6%) (p = 0.047), but deaths during induction were more frequent among m-bfm patients (13.8%) than in the hc group (6.4%) (p = 0.064). bone marrow relapses after complete remission were less common in the ic group than in the hc group (19.4% and 45.9%, respectively; p = 0.0001), but central nervous system relapses showed no difference (12.8% in the hc and 16.3% under ic; p = 0.6). the dfs rates at 10 years were higher for the ic group, regardless of the baseline risk.
Conclusions:
Ic reduces the frequency of relapses in all children in developing countries, when compared to previous therapy. a highly effective therapy such as m-bfm seems to be the most important predictor of outcome in children.