Unknown

Dataset Information

0

Favorable Trisomies and ETV6-RUNX1 Predict Cure in Low-Risk B-Cell Acute Lymphoblastic Leukemia: Results From Children's Oncology Group Trial AALL0331.


ABSTRACT:

Purpose

Children's Oncology Group (COG) AALL0331 tested whether pegaspargase intensification on a low-intensity chemotherapy backbone would improve the continuous complete remission (CCR) rate in a low-risk subset of children with standard-risk B-acute lymphoblastic leukemia (ALL).

Methods

AALL0331 enrolled 5,377 patients with National Cancer Institute standard-risk B-ALL (age 1-9 years, WBC < 50,000/μL) between 2005 and 2010. Following a common three-drug induction, a cohort of 1,857 eligible patients participated in the low-risk ALL random assignment. Low-risk criteria included no extramedullary disease, < 5% marrow blasts by day 15, end-induction marrow minimal residual disease < 0.1%, and favorable cytogenetics (ETV6-RUNX1 fusion or simultaneous trisomies of chromosomes 4, 10, and 17). Random assignment was to standard COG low-intensity therapy (including two pegaspargase doses, one each during induction and delayed intensification) with or without four additional pegaspargase doses at 3-week intervals during consolidation and interim maintenance. The study was powered to detect a 4% improvement in 6-year CCR rate from 92% to 96%.

Results

The 6-year CCR and overall survival (OS) rates for the entire low-risk cohort were 94.7% ± 0.6% and 98.7% ± 0.3%, respectively. The CCR rates were similar between arms (intensified pegaspargase 95.3% ± 0.8% v standard 94.0% ± 0.8%; P = .13) with no difference in OS (98.1% ± 0.5% v 99.2% ± 0.3%; P = .99). Compared to a subset of standard-risk study patients given identical therapy who had the same early response characteristics but did not have favorable or unfavorable cytogenetics, outcomes were significantly superior for low-risk patients (CCR hazard ratio 1.95; P = .0004; OS hazard ratio 5.42; P < .0001).

Conclusion

Standard COG therapy without intensified pegaspargase, which can easily be given as an outpatient with limited toxicity, cures nearly all children with B-ALL identified as low-risk by clinical, early response, and favorable cytogenetic criteria.

SUBMITTER: Mattano LA 

PROVIDER: S-EPMC8274747 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

altmetric image

Publications

Favorable Trisomies and <i>ETV6-RUNX1</i> Predict Cure in Low-Risk B-Cell Acute Lymphoblastic Leukemia: Results From Children's Oncology Group Trial AALL0331.

Mattano Leonard A LA   Devidas Meenakshi M   Maloney Kelly W KW   Wang Cindy C   Friedmann Alison M AM   Buckley Patrick P   Borowitz Michael J MJ   Carroll Andrew J AJ   Gastier-Foster Julie M JM   Heerema Nyla A NA   Kadan-Lottick Nina S NS   Matloub Yousif H YH   Marshall David T DT   Stork Linda C LC   Loh Mignon L ML   Raetz Elizabeth A EA   Wood Brent L BL   Hunger Stephen P SP   Carroll William L WL   Winick Naomi J NJ  

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20210319 14


<h4>Purpose</h4>Children's Oncology Group (COG) AALL0331 tested whether pegaspargase intensification on a low-intensity chemotherapy backbone would improve the continuous complete remission (CCR) rate in a low-risk subset of children with standard-risk B-acute lymphoblastic leukemia (ALL).<h4>Methods</h4>AALL0331 enrolled 5,377 patients with National Cancer Institute standard-risk B-ALL (age 1-9 years, WBC < 50,000/μL) between 2005 and 2010. Following a common three-drug induction, a cohort of 1  ...[more]

Similar Datasets

| S-EPMC11216990 | biostudies-literature
| S-EPMC11779914 | biostudies-literature
| S-EPMC8722219 | biostudies-literature
| S-EPMC3345278 | biostudies-literature
| S-EPMC3356560 | biostudies-literature
| S-EPMC6785433 | biostudies-literature
| S-EPMC3622520 | biostudies-literature
| S-EPMC8209579 | biostudies-literature
| S-EPMC2817026 | biostudies-literature
| S-EPMC3960636 | biostudies-literature