期刊
AMERICAN JOURNAL OF HEMATOLOGY
卷 93, 期 7, 页码 913-920出版社
WILEY
DOI: 10.1002/ajh.25124
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资金
- National Key Technology R&D Program of China [2007BAI04B03]
- National Science and Technology Major Project of the Ministry of Science and Technology of China [2017ZX09304029]
- National Natural Science Foundation of China [81200392, 81170504]
- Beijing Natural Science Foundation [7152054]
- Scientific Research Common Program of Beijing Municipal Commission of Education [KM201810025025]
- Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Grant [ZY201404]
- Beijing Municipal Administration of Hospitals DengFeng Program [DFL20151101]
- Capital Health and Development of Special Grant [2016-12091]
- Tianjin Science and Technology Program [12ZCDZSY18100]
- Children Cancer Foundation of Hong Kong
- New Sunshine Charity Foundation of China
Acute lymphoblastic leukemia (ALL) is the most common malignancy among children. The trial Chinese Children Leukemia Group (CCLG)-ALL 2008 was a prospective clinical trial designed to improve treatment outcome of childhood ALL through the first nation-wide collaborative study in China. Totally 2231 patients were recruited from ten tertiary hospitals in eight cities. The patients were stratified according to clinical-biological characteristics and early treatment response. Standard risk (SR) and intermediate risk (IR) groups were treated with a modified BFM based protocol, and there was 25%-50% dose reduction during intensification phases in the SR group. Patients in high risk (HR) group received a more intensive maintenance treatment. Minimal residual disease (MRD) monitoring with treatment adjustment was performed in two hospitals (the MRD group). Complete remission (CR) was achieved in 2100 patients (94.1%). At five years, the estimate for overall survival (OS) and event-free survival (EFS) of the whole group was 85.3% and 79.9%, respectively. The cumulative incidence of relapse (CIR) was 15.3% at five years. The OS, EFS and CIR for the SR group were 91.5%, 87.9%, and 9.7%, respectively. The outcome of the MRD group is better than the non-MRD group (5y-EFS: 82.4% vs 78.3%, P=.038; 5y-CIR: 10.7% vs 18.0%, P<.001). Our results demonstrated that the large-scale multicenter trial for pediatric ALL was feasible in China. Dose reduction in the SR group could achieve high EFS. MRD-based risk stratification might improve the treatment outcome for childhood ALL.
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