Outcome of children with newly diagnosed acute lymphoblastic leukemia treated with CCLG‐ALL 2008: The first nation‐wide prospective multicenter study in China

作者：Lei Cui, Zhigang Li, Yi-huan Chai, Jie Yu, Ju Gao, Xiaofan Zhu, Runming Jin, Xiaodong Shi, Le‐Ping Zhang, Yijin Gao, Ruidong Zhang, Huyong Zheng, Shaoyan Hu, Yinghui Cui, Yiping Zhu, Yao Zou, Margaret H.L. Ng, Yan Xiao, Junhui Li, Yonghong Zhang, Hailong He, Ying Xian, Tianyou Wang, Chi Kong Li, Min‐Yuan Wu, on behalf of the Chinese Children Leukemia Group(CCLG) · 发表于：American Journal of Hematology · 年份：2018 · DOI：10.1002/ajh.25124 · 被引用次数：149 · 研究领域：Acute Lymphoblastic Leukemia research、Childhood Cancer Survivors' Quality of Life、Neutropenia and Cancer Infections

Acute lymphoblastic leukemia (ALL) is the most common malignancy among children. The trial Chinese Children Leukemia Group (CCLG)-ALL 2008 was a prospective clinical trial designed to improve treatment outcome of childhood ALL through the first nation-wide collaborative study in China. Totally 2231 patients were recruited from ten tertiary hospitals in eight cities. The patients were stratified according to clinical-biological characteristics and early treatment response. Standard risk (SR) and intermediate risk (IR) groups were treated with a modified BFM based protocol, and there was 25%-50% dose reduction during intensification phases in the SR group. Patients in high risk (HR) group received a more intensive maintenance treatment. Minimal residual disease (MRD) monitoring with treatment adjustment was performed in two hospitals (the MRD group). Complete remission (CR) was achieved in 2100 patients (94.1%). At five years, the estimate for overall survival (OS) and event-free survival (EFS) of the whole group was 85.3% and 79.9%, respectively. The cumulative incidence of relapse (CIR) was 15.3% at five years. The OS, EFS and CIR for the SR group were 91.5%, 87.9%, and 9.7%, respectively. The outcome of the MRD group is better than the non-MRD group (5y-EFS: 82.4% vs 78.3%, P = .038; 5y-CIR: 10.7% vs 18.0%, P < .001). Our results demonstrated that the large-scale multicenter trial for pediatric ALL was feasible in China. Dose reduction in the SR group could achieve high EFS....