Long-term results of Taiwan Pediatric Oncology Group studies 1997 and 2002 for childhood acute lymphoblastic leukemia

D. C. Liang; C. P. Yang; D. T. Lin; I. J. Hung; K. H. Lin; J. S. Chen; C. C. Hsiao; T. T. Chang; C. T. Peng; M. T. Lin; T. K. Chang; T. H. Jaing; H. C. Liu; L. Y. Wang; T. C. Yeh; S. T. Jou; M. Y. Lu; C. N. Cheng; J. M. Sheen; S. S. Chiou; K. H. Wu; G. Y. Hung; R. L. Chen; S. H. Chen; S. N. Cheng; Y. H. Chang; B. W. Chen; W. L. Ho; J. L. Wang; S. T. Lin; Y. L. Hsieh; S. C. Wang; H. H. Chang; Y. L. Yang; F. L. Huang; C. Y. Chang; W. H. Chang; K. S. Lin

doi:10.1038/leu.2009.248

Long-term results of Taiwan Pediatric Oncology Group studies 1997 and 2002 for childhood acute lymphoblastic leukemia

D. C. Liang, C. P. Yang, D. T. Lin, I. J. Hung, K. H. Lin, J. S. Chen, C. C. Hsiao, T. T. Chang, C. T. Peng, M. T. Lin, T. K. Chang, T. H. Jaing, H. C. Liu, L. Y. Wang, T. C. Yeh, S. T. Jou, M. Y. Lu, C. N. Cheng, J. M. Sheen, S. S. ChiouK. H. Wu, G. Y. Hung, R. L. Chen, S. H. Chen, S. N. Cheng, Y. H. Chang, B. W. Chen, W. L. Ho, J. L. Wang, S. T. Lin, Y. L. Hsieh, S. C. Wang, H. H. Chang, Y. L. Yang, F. L. Huang, C. Y. Chang, W. H. Chang, K. S. Lin

Taipei Medical University Hospital

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Abstract

The long-term outcome of 1390 children with acute lymphoblastic leukemia (ALL), treated in two successive clinical trials (Taiwan Pediatric Oncology Group (TPOG)-ALL-97 and TPOG-ALL-2002) between 1997 and 2007, is reported. The event-free survival improved significantly (P0.0004) over this period, 69.31.9% in 1997-2001 to 77.41.7% in 2002-2007. A randomized trial in TPOG-97 testing L-asparaginase versus epidoxorubicin in combination with vincristine and prednisolone for remission induction in standard-risk (SR; low-risk) patients yielded similar outcomes. Another randomized trial, in TPOG-2002, showed that for SR patients, two reinduction courses did not improve long-term outcome over one course. Decreasing use of prophylactic cranial irradiation in the period 1997-2008 was not associated with increased rates of CNS relapse, prompting complete omission of prophylactic cranial irradiation from TPOG protocols, beginning in 2009. Decreased use of etoposide and cranial irradiation likely contributed to the low incidence of second cancers. High-risk B-lineage ALL, T-cell, CD10 negativity, t(9;22), infant, and higher leukocyte count were consistently adverse factors, whereas hyperdiploidy 50 was a consistently favorable factor. Higher leukocyte count and t(9;22) retained prognostic significance in both TPOG-97 and TPOG-2002 by multivariate analysis. Although long-term outcome in TPOG clinical trials is comparable with results being reported worldwide, the persistent strength of certain prognostic variables and the lower frequencies of favorable outcome predictors, such as ETV6-RUNX1 and hyperdiploidy 50, in Taiwanese children warrant renewed effort to cure a higher proportion of patients while preserving their quality of life.

Original language	English
Pages (from-to)	397-405
Number of pages	9
Journal	Leukemia
Volume	24
Issue number	2
DOIs	https://doi.org/10.1038/leu.2009.248
Publication status	Published - Feb 2010

Keywords

Acute lymphoblastic leukemia
Children
Treatment results

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/leu.2009.248

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Liang, D. C., Yang, C. P., Lin, D. T., Hung, I. J., Lin, K. H., Chen, J. S., Hsiao, C. C., Chang, T. T., Peng, C. T., Lin, M. T., Chang, T. K., Jaing, T. H., Liu, H. C., Wang, L. Y., Yeh, T. C., Jou, S. T., Lu, M. Y., Cheng, C. N., Sheen, J. M., ... Lin, K. S. (2010). Long-term results of Taiwan Pediatric Oncology Group studies 1997 and 2002 for childhood acute lymphoblastic leukemia. Leukemia, 24(2), 397-405. https://doi.org/10.1038/leu.2009.248

Liang, DC, Yang, CP, Lin, DT, Hung, IJ, Lin, KH, Chen, JS, Hsiao, CC, Chang, TT, Peng, CT, Lin, MT, Chang, TK, Jaing, TH, Liu, HC, Wang, LY, Yeh, TC, Jou, ST, Lu, MY, Cheng, CN, Sheen, JM, Chiou, SS, Wu, KH, Hung, GY, Chen, RL, Chen, SH, Cheng, SN, Chang, YH, Chen, BW, Ho, WL, Wang, JL, Lin, ST, Hsieh, YL, Wang, SC, Chang, HH, Yang, YL, Huang, FL, Chang, CY, Chang, WH & Lin, KS 2010, 'Long-term results of Taiwan Pediatric Oncology Group studies 1997 and 2002 for childhood acute lymphoblastic leukemia', Leukemia, vol. 24, no. 2, pp. 397-405. https://doi.org/10.1038/leu.2009.248

@article{9bc75f2c21d4442aa5f91197df2bf4b6,

title = "Long-term results of Taiwan Pediatric Oncology Group studies 1997 and 2002 for childhood acute lymphoblastic leukemia",

abstract = "The long-term outcome of 1390 children with acute lymphoblastic leukemia (ALL), treated in two successive clinical trials (Taiwan Pediatric Oncology Group (TPOG)-ALL-97 and TPOG-ALL-2002) between 1997 and 2007, is reported. The event-free survival improved significantly (P0.0004) over this period, 69.31.9% in 1997-2001 to 77.41.7% in 2002-2007. A randomized trial in TPOG-97 testing L-asparaginase versus epidoxorubicin in combination with vincristine and prednisolone for remission induction in standard-risk (SR; low-risk) patients yielded similar outcomes. Another randomized trial, in TPOG-2002, showed that for SR patients, two reinduction courses did not improve long-term outcome over one course. Decreasing use of prophylactic cranial irradiation in the period 1997-2008 was not associated with increased rates of CNS relapse, prompting complete omission of prophylactic cranial irradiation from TPOG protocols, beginning in 2009. Decreased use of etoposide and cranial irradiation likely contributed to the low incidence of second cancers. High-risk B-lineage ALL, T-cell, CD10 negativity, t(9;22), infant, and higher leukocyte count were consistently adverse factors, whereas hyperdiploidy 50 was a consistently favorable factor. Higher leukocyte count and t(9;22) retained prognostic significance in both TPOG-97 and TPOG-2002 by multivariate analysis. Although long-term outcome in TPOG clinical trials is comparable with results being reported worldwide, the persistent strength of certain prognostic variables and the lower frequencies of favorable outcome predictors, such as ETV6-RUNX1 and hyperdiploidy 50, in Taiwanese children warrant renewed effort to cure a higher proportion of patients while preserving their quality of life.",

keywords = "Acute lymphoblastic leukemia, Children, Treatment results",

author = "Liang, {D. C.} and Yang, {C. P.} and Lin, {D. T.} and Hung, {I. J.} and Lin, {K. H.} and Chen, {J. S.} and Hsiao, {C. C.} and Chang, {T. T.} and Peng, {C. T.} and Lin, {M. T.} and Chang, {T. K.} and Jaing, {T. H.} and Liu, {H. C.} and Wang, {L. Y.} and Yeh, {T. C.} and Jou, {S. T.} and Lu, {M. Y.} and Cheng, {C. N.} and Sheen, {J. M.} and Chiou, {S. S.} and Wu, {K. H.} and Hung, {G. Y.} and Chen, {R. L.} and Chen, {S. H.} and Cheng, {S. N.} and Chang, {Y. H.} and Chen, {B. W.} and Ho, {W. L.} and Wang, {J. L.} and Lin, {S. T.} and Hsieh, {Y. L.} and Wang, {S. C.} and Chang, {H. H.} and Yang, {Y. L.} and Huang, {F. L.} and Chang, {C. Y.} and Chang, {W. H.} and Lin, {K. S.}",

year = "2010",

month = feb,

doi = "10.1038/leu.2009.248",

language = "English",

volume = "24",

pages = "397--405",

journal = "Leukemia",

issn = "0887-6924",

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T1 - Long-term results of Taiwan Pediatric Oncology Group studies 1997 and 2002 for childhood acute lymphoblastic leukemia

AU - Liang, D. C.

AU - Yang, C. P.

AU - Lin, D. T.

AU - Hung, I. J.

AU - Lin, K. H.

AU - Chen, J. S.

AU - Hsiao, C. C.

AU - Chang, T. T.

AU - Peng, C. T.

AU - Lin, M. T.

AU - Chang, T. K.

AU - Jaing, T. H.

AU - Liu, H. C.

AU - Wang, L. Y.

AU - Yeh, T. C.

AU - Jou, S. T.

AU - Lu, M. Y.

AU - Cheng, C. N.

AU - Sheen, J. M.

AU - Chiou, S. S.

AU - Wu, K. H.

AU - Hung, G. Y.

AU - Chen, R. L.

AU - Chen, S. H.

AU - Cheng, S. N.

AU - Chang, Y. H.

AU - Chen, B. W.

AU - Ho, W. L.

AU - Wang, J. L.

AU - Lin, S. T.

AU - Hsieh, Y. L.

AU - Wang, S. C.

AU - Chang, H. H.

AU - Yang, Y. L.

AU - Huang, F. L.

AU - Chang, C. Y.

AU - Chang, W. H.

AU - Lin, K. S.

PY - 2010/2

Y1 - 2010/2

N2 - The long-term outcome of 1390 children with acute lymphoblastic leukemia (ALL), treated in two successive clinical trials (Taiwan Pediatric Oncology Group (TPOG)-ALL-97 and TPOG-ALL-2002) between 1997 and 2007, is reported. The event-free survival improved significantly (P0.0004) over this period, 69.31.9% in 1997-2001 to 77.41.7% in 2002-2007. A randomized trial in TPOG-97 testing L-asparaginase versus epidoxorubicin in combination with vincristine and prednisolone for remission induction in standard-risk (SR; low-risk) patients yielded similar outcomes. Another randomized trial, in TPOG-2002, showed that for SR patients, two reinduction courses did not improve long-term outcome over one course. Decreasing use of prophylactic cranial irradiation in the period 1997-2008 was not associated with increased rates of CNS relapse, prompting complete omission of prophylactic cranial irradiation from TPOG protocols, beginning in 2009. Decreased use of etoposide and cranial irradiation likely contributed to the low incidence of second cancers. High-risk B-lineage ALL, T-cell, CD10 negativity, t(9;22), infant, and higher leukocyte count were consistently adverse factors, whereas hyperdiploidy 50 was a consistently favorable factor. Higher leukocyte count and t(9;22) retained prognostic significance in both TPOG-97 and TPOG-2002 by multivariate analysis. Although long-term outcome in TPOG clinical trials is comparable with results being reported worldwide, the persistent strength of certain prognostic variables and the lower frequencies of favorable outcome predictors, such as ETV6-RUNX1 and hyperdiploidy 50, in Taiwanese children warrant renewed effort to cure a higher proportion of patients while preserving their quality of life.

AB - The long-term outcome of 1390 children with acute lymphoblastic leukemia (ALL), treated in two successive clinical trials (Taiwan Pediatric Oncology Group (TPOG)-ALL-97 and TPOG-ALL-2002) between 1997 and 2007, is reported. The event-free survival improved significantly (P0.0004) over this period, 69.31.9% in 1997-2001 to 77.41.7% in 2002-2007. A randomized trial in TPOG-97 testing L-asparaginase versus epidoxorubicin in combination with vincristine and prednisolone for remission induction in standard-risk (SR; low-risk) patients yielded similar outcomes. Another randomized trial, in TPOG-2002, showed that for SR patients, two reinduction courses did not improve long-term outcome over one course. Decreasing use of prophylactic cranial irradiation in the period 1997-2008 was not associated with increased rates of CNS relapse, prompting complete omission of prophylactic cranial irradiation from TPOG protocols, beginning in 2009. Decreased use of etoposide and cranial irradiation likely contributed to the low incidence of second cancers. High-risk B-lineage ALL, T-cell, CD10 negativity, t(9;22), infant, and higher leukocyte count were consistently adverse factors, whereas hyperdiploidy 50 was a consistently favorable factor. Higher leukocyte count and t(9;22) retained prognostic significance in both TPOG-97 and TPOG-2002 by multivariate analysis. Although long-term outcome in TPOG clinical trials is comparable with results being reported worldwide, the persistent strength of certain prognostic variables and the lower frequencies of favorable outcome predictors, such as ETV6-RUNX1 and hyperdiploidy 50, in Taiwanese children warrant renewed effort to cure a higher proportion of patients while preserving their quality of life.

KW - Acute lymphoblastic leukemia

KW - Children

KW - Treatment results

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JO - Leukemia

JF - Leukemia

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ER -

Long-term results of Taiwan Pediatric Oncology Group studies 1997 and 2002 for childhood acute lymphoblastic leukemia

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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