Outcome of children with multiply relapsed B-cell acute lymphoblastic leukemia: a therapeutic advances in childhood leukemia & lymphoma study

Weili Sun, Jemily Malvar, Richard Sposto, Anupam Verma, Jennifer J. Wilkes, Robyn Dennis, Kenneth Heym, Theodore W. Laetsch, Melissa Widener, Susan R. Rheingold, Javier Oesterheld, Nobuko Hijiya, Maria Luisa Sulis, Van Huynh, Andrew E. Place, Henrique Bittencourt, Raymond Hutchinson, Yoav Messinger, Bill Chang, Yousif MatloubDavid S. Ziegler, Rebecca Gardner, Todd Cooper, Francesco Ceppi, Michelle Hermiston, Luciano Dalla-Pozza, Kirk R. Schultz, Paul Gaynon, Alan S. Wayne, James A. Whitlock

Research output: Contribution to journalArticle

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Abstract

The survival of pediatric patients with multiply relapsed and/or refractory (R/R) B-cell acute lymphoblastic leukemia has historically been very poor; however, data are limited in the current era. We conducted a retrospective study to determine the outcome of multiply R/R childhood B-ALL treated at 24 TACL institutions between 2005 and 2013. Patient information, treatment, and response were collected. Prognostic factors influencing the complete remission (CR) rate and event-free survival (EFS) were analyzed. The analytic set included 578 salvage treatment attempts among 325 patients. CR rates (mean ± SE) were 51 ± 4% for patients with bone marrow R/R B-ALL who underwent a second salvage attempt, 37 ± 6% for a third attempt, and 31 ± 6% for the fourth through eighth attempts combined. For patients achieving a CR after their second, third, and fourth through eighth attempts, the 2 year EFS was 41 ± 6%, 13 ± 7%, and 27 ± 13% respectively. Our results showed slight improvement when compared to previous studies. This is the largest and most recent study to date that evaluates the outcome of this patient population. Our data will provide detailed reference for the evaluation of new agents being developed for childhood B-ALL.

Original languageEnglish (US)
Pages (from-to)2316-2325
Number of pages10
JournalLeukemia
Volume32
Issue number11
DOIs
StatePublished - Nov 1 2018

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Lymphoma
Leukemia
B-Lymphocytes
Disease-Free Survival
Therapeutics
Salvage Therapy
Retrospective Studies
Bone Marrow
Pediatrics
Survival
Population

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Outcome of children with multiply relapsed B-cell acute lymphoblastic leukemia : a therapeutic advances in childhood leukemia & lymphoma study. / Sun, Weili; Malvar, Jemily; Sposto, Richard; Verma, Anupam; Wilkes, Jennifer J.; Dennis, Robyn; Heym, Kenneth; Laetsch, Theodore W.; Widener, Melissa; Rheingold, Susan R.; Oesterheld, Javier; Hijiya, Nobuko; Sulis, Maria Luisa; Huynh, Van; Place, Andrew E.; Bittencourt, Henrique; Hutchinson, Raymond; Messinger, Yoav; Chang, Bill; Matloub, Yousif; Ziegler, David S.; Gardner, Rebecca; Cooper, Todd; Ceppi, Francesco; Hermiston, Michelle; Dalla-Pozza, Luciano; Schultz, Kirk R.; Gaynon, Paul; Wayne, Alan S.; Whitlock, James A.

In: Leukemia, Vol. 32, No. 11, 01.11.2018, p. 2316-2325.

Research output: Contribution to journalArticle

Sun, W, Malvar, J, Sposto, R, Verma, A, Wilkes, JJ, Dennis, R, Heym, K, Laetsch, TW, Widener, M, Rheingold, SR, Oesterheld, J, Hijiya, N, Sulis, ML, Huynh, V, Place, AE, Bittencourt, H, Hutchinson, R, Messinger, Y, Chang, B, Matloub, Y, Ziegler, DS, Gardner, R, Cooper, T, Ceppi, F, Hermiston, M, Dalla-Pozza, L, Schultz, KR, Gaynon, P, Wayne, AS & Whitlock, JA 2018, 'Outcome of children with multiply relapsed B-cell acute lymphoblastic leukemia: a therapeutic advances in childhood leukemia & lymphoma study', Leukemia, vol. 32, no. 11, pp. 2316-2325. https://doi.org/10.1038/s41375-018-0094-0
Sun, Weili ; Malvar, Jemily ; Sposto, Richard ; Verma, Anupam ; Wilkes, Jennifer J. ; Dennis, Robyn ; Heym, Kenneth ; Laetsch, Theodore W. ; Widener, Melissa ; Rheingold, Susan R. ; Oesterheld, Javier ; Hijiya, Nobuko ; Sulis, Maria Luisa ; Huynh, Van ; Place, Andrew E. ; Bittencourt, Henrique ; Hutchinson, Raymond ; Messinger, Yoav ; Chang, Bill ; Matloub, Yousif ; Ziegler, David S. ; Gardner, Rebecca ; Cooper, Todd ; Ceppi, Francesco ; Hermiston, Michelle ; Dalla-Pozza, Luciano ; Schultz, Kirk R. ; Gaynon, Paul ; Wayne, Alan S. ; Whitlock, James A. / Outcome of children with multiply relapsed B-cell acute lymphoblastic leukemia : a therapeutic advances in childhood leukemia & lymphoma study. In: Leukemia. 2018 ; Vol. 32, No. 11. pp. 2316-2325.
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AU - Sun, Weili

AU - Malvar, Jemily

AU - Sposto, Richard

AU - Verma, Anupam

AU - Wilkes, Jennifer J.

AU - Dennis, Robyn

AU - Heym, Kenneth

AU - Laetsch, Theodore W.

AU - Widener, Melissa

AU - Rheingold, Susan R.

AU - Oesterheld, Javier

AU - Hijiya, Nobuko

AU - Sulis, Maria Luisa

AU - Huynh, Van

AU - Place, Andrew E.

AU - Bittencourt, Henrique

AU - Hutchinson, Raymond

AU - Messinger, Yoav

AU - Chang, Bill

AU - Matloub, Yousif

AU - Ziegler, David S.

AU - Gardner, Rebecca

AU - Cooper, Todd

AU - Ceppi, Francesco

AU - Hermiston, Michelle

AU - Dalla-Pozza, Luciano

AU - Schultz, Kirk R.

AU - Gaynon, Paul

AU - Wayne, Alan S.

AU - Whitlock, James A.

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N2 - The survival of pediatric patients with multiply relapsed and/or refractory (R/R) B-cell acute lymphoblastic leukemia has historically been very poor; however, data are limited in the current era. We conducted a retrospective study to determine the outcome of multiply R/R childhood B-ALL treated at 24 TACL institutions between 2005 and 2013. Patient information, treatment, and response were collected. Prognostic factors influencing the complete remission (CR) rate and event-free survival (EFS) were analyzed. The analytic set included 578 salvage treatment attempts among 325 patients. CR rates (mean ± SE) were 51 ± 4% for patients with bone marrow R/R B-ALL who underwent a second salvage attempt, 37 ± 6% for a third attempt, and 31 ± 6% for the fourth through eighth attempts combined. For patients achieving a CR after their second, third, and fourth through eighth attempts, the 2 year EFS was 41 ± 6%, 13 ± 7%, and 27 ± 13% respectively. Our results showed slight improvement when compared to previous studies. This is the largest and most recent study to date that evaluates the outcome of this patient population. Our data will provide detailed reference for the evaluation of new agents being developed for childhood B-ALL.

AB - The survival of pediatric patients with multiply relapsed and/or refractory (R/R) B-cell acute lymphoblastic leukemia has historically been very poor; however, data are limited in the current era. We conducted a retrospective study to determine the outcome of multiply R/R childhood B-ALL treated at 24 TACL institutions between 2005 and 2013. Patient information, treatment, and response were collected. Prognostic factors influencing the complete remission (CR) rate and event-free survival (EFS) were analyzed. The analytic set included 578 salvage treatment attempts among 325 patients. CR rates (mean ± SE) were 51 ± 4% for patients with bone marrow R/R B-ALL who underwent a second salvage attempt, 37 ± 6% for a third attempt, and 31 ± 6% for the fourth through eighth attempts combined. For patients achieving a CR after their second, third, and fourth through eighth attempts, the 2 year EFS was 41 ± 6%, 13 ± 7%, and 27 ± 13% respectively. Our results showed slight improvement when compared to previous studies. This is the largest and most recent study to date that evaluates the outcome of this patient population. Our data will provide detailed reference for the evaluation of new agents being developed for childhood B-ALL.

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