Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy

James B. Nachman, Harland N. Sather, Martha G. Sensel, Michael E. Trigg, Joel M. Cherlow, John N. Lukens, Lawrence Wolff, Fatih M. Uckun, Paul S. Gaynon

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Abstract

Background: Children with high-risk acute lymphoblastic leukemia (ALL) who have a slow response to initial chemotherapy (more than 25 percent blasts in the bone marrow on day 7) have a poor outcome despite intensive therapy. We conducted a randomized trial in which such patients were treated with either an augmented intensive regimen of post-induction chemotherapy or a standard regimen of intensive post-induction chemotherapy. Methods: Between January 1991 and June 1995, 311 children with newly diagnosed ALL who were either 1 to 9 years of age with white-cell counts of at least 50,000 per cubic millimeter or 10 years of age or older, had a slow response to initial therapy, and entered remission at the end of induction chemotherapy were randomly assigned to receive standard therapy (156 children) or augmented therapy (155). Those with lymphomatous features were excluded. Event-free survival and overall survival were assessed from the end of induction treatment. Results: The outcome at five years was significantly better in the augmented-therapy group than in the standard-therapy group (Kaplan-Meier estimate of event-free survival [±SD]: 75.0±3.8 vs. 55.0±4.5 percent, P

Original languageEnglish (US)
Pages (from-to)1663-1671
Number of pages9
JournalNew England Journal of Medicine
Volume338
Issue number23
DOIs
StatePublished - Jun 4 1998

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Induction Chemotherapy
Group Psychotherapy
Disease-Free Survival
Therapeutics
Kaplan-Meier Estimate
Cell Count
Bone Marrow
Drug Therapy
Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Nachman, J. B., Sather, H. N., Sensel, M. G., Trigg, M. E., Cherlow, J. M., Lukens, J. N., ... Gaynon, P. S. (1998). Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy. New England Journal of Medicine, 338(23), 1663-1671. https://doi.org/10.1056/NEJM199806043382304

Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy. / Nachman, James B.; Sather, Harland N.; Sensel, Martha G.; Trigg, Michael E.; Cherlow, Joel M.; Lukens, John N.; Wolff, Lawrence; Uckun, Fatih M.; Gaynon, Paul S.

In: New England Journal of Medicine, Vol. 338, No. 23, 04.06.1998, p. 1663-1671.

Research output: Contribution to journalArticle

Nachman, JB, Sather, HN, Sensel, MG, Trigg, ME, Cherlow, JM, Lukens, JN, Wolff, L, Uckun, FM & Gaynon, PS 1998, 'Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy', New England Journal of Medicine, vol. 338, no. 23, pp. 1663-1671. https://doi.org/10.1056/NEJM199806043382304
Nachman, James B. ; Sather, Harland N. ; Sensel, Martha G. ; Trigg, Michael E. ; Cherlow, Joel M. ; Lukens, John N. ; Wolff, Lawrence ; Uckun, Fatih M. ; Gaynon, Paul S. / Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy. In: New England Journal of Medicine. 1998 ; Vol. 338, No. 23. pp. 1663-1671.
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