Korean J Hematol.  2010 Jun;45(2):109-114. 10.5045/kjh.2010.45.2.109.

Improved outcome in childhood ALL with intensive consolidation and hematopoietic stem cell transplant

• Park JA
• Ghim T
• Bae KW
• Koh KN
• Im HJ
• Seo JJ

• KMID: 2083543
• DOI: http://doi.org/10.5045/kjh.2010.45.2.109

Abstract

BACKGROUND
Despite advances in chemotherapy, the prognosis of relapsed acute lymphoblastic leukemia (ALL) remains poor. Few studies on relapsed ALL have reported the importance of intensive consolidation followed with or without allogeneic hematopoietic stem cell transplantation (HSCT).
METHODS
We evaluated the post-relapse outcomes in 47 Korean children with a first marrow relapse, and analyzed the prognostic factors.
RESULTS
A second complete remission (CR) was achieved in 40 patients (85.1%), and at the time of this study, second CR was maintained in 12 of these patients. The estimated 3-yr event-free survival (EFS) rate after the first marrow relapse was 29.8+/-6.7%, and the overall survival (OS) rate was 45.3+/-7.5%. We found that second remission, consolidation of pediatric oncology group chemotherapy regimen (POG 9411), and HSCT significantly affected the outcome of the disease after relapse (P<0.001; P=0.004; P=0.05).
CONCLUSION
The results of our study revealed that an intensified POG 9411 consolidation chemotherapy regimen followed by HSCT can improve the outcome of patients with relapsed ALL.

Keyword

Acute lymphoblastic leukemia; Relapse; Intensive consolidation; Hematopoietic stem cell transplantation

MeSH Terms

Bone Marrow
Child
Consolidation Chemotherapy
Disease-Free Survival
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells
Humans
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prognosis
Recurrence
Transplants

Figure

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  Fig. 1 Treatment overview and outcomes for patients with marrow-relapse ALL.

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  Fig. 2 Event-free survival rates and overall survival rates of patients with marrow-relapse ALL. Event-free survival rates differed due to the achievement of second remission (A), consolidation chemotherapy after remission (B), and allogeneic hematopoeitic stem call transplantation (HSCT) (C). Overall survival rates were significantly affected by the achievement of second remission (D).

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