Article

Systematic review and meta-analysis of randomized trials of central nervous system directed therapy for childhood acute lymphoblastic leukemia.

University of Oxford, Oxford, UK. .
Pediatric Blood & Cancer (impact factor: 1.89). 06/2012; DOI:10.1002/pbc.24228
Source: PubMed

ABSTRACT Treatment of the central nervous system (CNS) is an essential therapy component for childhood acute lymphoblastic leukemia (ALL). Individual patient data from 47 trials addressing 16 CNS treatment comparisons were analyzed. Event-free survival (EFS) was similar for radiotherapy versus intrathecal (IT), and radiotherapy plus IT versus IV methotrexate (IV MTX) plus IT. Triple intrathecal therapy (TIT) gave similar EFS but poorer survival than intrathecal methotrexate (IT MTX), but additional IV MTX improved both outcomes. One trial resulted in similar EFS and survival with IV MTX plus IT MTX versus TIT alone. Radiotherapy can generally be replaced by IT therapy. TIT should be used with effective systemic therapy such as IV MTX. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc.

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Keywords

16 CNS treatment comparisons
 
47 trials
 
additional IV MTX
 
central nervous system
 
childhood acute lymphoblastic leukemia
 
effective systemic therapy
 
EFS
 
essential therapy component
 
Event-free survival
 
Inc
 
Individual patient data
 
IV methotrexate
 
IV MTX
 
Pediatr Blood Cancer © 2012 Wiley Periodicals
 
poorer survival
 
similar EFS
 
Triple intrathecal therapy
 

Sue Richards