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ctt-journal > Boychenko et al. (Abstract)

Boychenko et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract56

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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Is intensive chemotherapy for childhood acute lymphoblastic leukemia always better? A Moscow–Saint Petersburg experience with three different regimens of therapy

Elmira G. Boychenko1, Alexander I. Karachunskiy2, Margarita B. Belogurova3, Eleonora M. Petrova1, Natalya V. Myakova2, Dmitry V. Litvinov2, Svetlana N. Lagoiko2, Natalya I. Ponomareva2, Konstantin L. Kondratchik2

1City Children’s Hospital No.1, St. Petersburg, Russia; 2Federal Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia; 3City Clinical Hospital No. 31, St. Petersburg, Russia

Correspondence: Elmira G. Boychenko, City Children’s Hospital No. 1, 14, Avangardnaya str., St. Petersburg, 198205, Russia, E-mail: boychenko-elmira@spam is badyandex.ru

Abstract

Purpose: To identify an optimal strategy of chemotherapy for childhood acute lymphoblastic leukemia (ALL) in Russia.

Method: A comparative analysis of three chemotherapy regimens (modified version of BFM-protocol [ALL-BFM 90m], two versions of ALL-Moscow-Berlin protocol [ALL-MB 91, ALL-MB 2002], and two modified versions of the German study COALL-92 [PECO-92, COALL-Saint Petersburg 92]) was performed in the pediatric oncology/hematology centers of Moscow and Saint Petersburg. Outcomes were examined in two time periods. Between 1993 and 1999, 477 newly diagnosed patients with ALL aged 0–18 years were treated with three protocols: ALL-BFM 90m (n=139), ALL-MB 91 (n=124), and PECO-92 (n=214). From April 2002 to January 2007, patients were treated according to the protocols ALL-MB 2002 (n=292) and COALL-Saint Petersburg 92 (n=126). Two treatment strategies were implemented: intensive polychemotherapy (ALL-BFM 90m, COALL-92m) and non-intensive prolonged chemotherapy on ALL-MB protocols (detailed information concerning the protocols' design has been published).

Results: Over the first time interval the 13-year event-free and overall survival probabilities (pEFS/ pOS) were 75%±4% / 80%±4% on ALL-BFM 90m, 72%±4% / 78%±4% on ALL-MB 91 and 60%±3% / 70%±3% on PECO-92. The induction death (ID) rate was 2.9%, 3.2% and 3.3%; and the remission death rate was 2.9%, 0.8% and 4.2%, respectively (n.s.). Relapses occurred in 16.5%, 17.7%, and 26.6% of patients respectively (p=0.028 BFM-PECO). Analysis over the second time interval did not reveal significant survival differences: the 7-year pEFS/ pOS by protocols ALL-MB 2002 and COALL-Saint Petersburg 92 were 78%±3%/ 80%±5% and 78%±4%/ 83%±4%. The ID rate was 1.4%, and 0.8% (n.s.); remission death rate was 2.1% and 6.3% (р=0.036). Relapses occurred in 16.1% and 11.9% of instances, respectively (n.s.).

Conclusion: Almost identical results were achieved over the second time period with both treatment strategies. However, the lower toxicity and easier implementation of ALL-MB 2002 appear to be crucial factors for the choice of an optimal treatment strategy for childhood ALL in Russia.

Keywords: acute lymphoblastic leukemia, children, intensive chemotherapy