Improved Survival for Children and Adolescents With Acute Lymphoblastic Leukemia Between 1990 and 2005: A Report From the Children's Oncology Group

University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO 80045, USA.
Journal of Clinical Oncology (Impact Factor: 18.43). 03/2012; 30(14):1663-9. DOI: 10.1200/JCO.2011.37.8018
Source: PubMed

ABSTRACT To examine population-based improvements in survival and the impact of clinical covariates on outcome among children and adolescents with acute lymphoblastic leukemia (ALL) enrolled onto Children's Oncology Group (COG) clinical trials between 1990 and 2005.
In total, 21,626 persons age 0 to 22 years were enrolled onto COG ALL clinical trials from 1990 to 2005, representing 55.8% of ALL cases estimated to occur among US persons younger than age 20 years during this period. This period was divided into three eras (1990-1994, 1995-1999, and 2000-2005) that included similar patient numbers to examine changes in 5- and 10-year survival over time and the relationship of those changes in survival to clinical covariates, with additional analyses of cause of death.
Five-year survival rates increased from 83.7% in 1990-1994 to 90.4% in 2000-2005 (P < .001). Survival improved significantly in all subgroups (except for infants age ≤ 1 year), including males and females; those age 1 to 9 years, 10+ years, or 15+ years; in whites, blacks, and other races; in Hispanics, non-Hispanics, and patients of unknown ethnicity; in those with B-cell or T-cell immunophenotype; and in those with National Cancer Institute (NCI) standard- or high-risk clinical features. Survival rates for infants changed little, but death following relapse/disease progression decreased and death related to toxicity increased.
This study documents ongoing survival improvements for children and adolescents with ALL. Thirty-six percent of deaths occurred among children with NCI standard-risk features emphasizing that efforts to further improve survival must be directed at both high-risk subsets and at those children predicted to have an excellent chance for cure.

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Available from: Meenakshi Devidas, Mar 14, 2014
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    • "Pomimo znacznych postępów w onkologii i transplantologii komórkowej u dzieci, ciągle śmiertelność zależna od leczenia (TRM; treatment-related mortality) pozostaje zbyt wysoka. W najczęstszej chorobie nowotworowej, ostrej białaczce limfoblastycznej, TRM wynosi 2–4% [7] [8] [9]. Najczęstszą przyczyną zgonów są infekcje, a w grupie pacjentów standardowego ryzyka ALL zgony z powodu zakażenia są równie częste jak nawroty białaczki [10] [11]. "
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    Pediatria polska 02/2015; 90(1):26-31. DOI:10.1016/j.pepo.2014.11.004
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    • "Some rare genetic syndromes exposed under radio therapy, and heavyweight born children are instances of some other factors which may improve the risk of ALL.The rate of survival in childhood ALL had a significant increase in some countries, during more than four decades (26). Five-year survival rates, since 1990 to 1994 raised to 83.7% (27). Some countries have achievedthe rate of long-term survival, in more than 80% of children suffering from ALL from 1 to 10 years old (28, 29). "
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    07/2014; 4(3):118-26.
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    • "Leukemia is the most common childhood malignancy, of which acute lymphoblastic leukemia (ALL) represents the largest sub-type, accounting for nearly 75% of newly diagnosed cases. Despite remarkable outcome improvement over the last 40 years, recent data suggest that standard therapy fails in 10–20% of newly diagnosed patients (1), and given its incidence, ALL remains the leading cause of cancer-related mortality under age 19 years (2). Survival for children with relapsed ALL is poor, reaching only 15% in those with early bone marrow relapse (3). "
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