ETV6::RUNX1 Acute Lymphoblastic Leukemia: how much therapy is needed for cure?

被引：1

作者：

Ostergaard, Anna ^{[1
]}

Fiocco, Marta ^{[1
,2
,3
]}

de Groot-Kruseman, Hester ^{[1
,4
]}

Moorman, Anthony V. ^{[5
,6
]}

Vora, Ajay ^{[6
,7
]}

Zimmermann, Martin ^{[8
,9
]}

Schrappe, Martin ^{[9
,10
]}

Biondi, Andrea ^{[11
,12
]}

Escherich, Gabriele ^{[13
,14
]}

Stary, Jan ^{[15
]}

Imai, Chihaya ^{[16
,17
]}

Imamura, Toshihiko ^{[18
,19
]}

Heyman, Mats ^{[20
,21
,22
]}

Schmiegelow, Kjeld ^{[23
,24
]}

Pieters, Rob ^{[1
,4
]}

机构：

[1] Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands

[2] Leiden Univ, Math Inst, Leiden, Netherlands

[3] Leiden Univ, Dept Biomed Sci, Sect Med Stat, Med Ctr, Leiden, Netherlands

[4] Dutch Childhood Oncol Grp DCOG, Utrecht, Netherlands

[5] Newcastle Univ, Translat & Clin Res Inst, Leukaemia Res Cytogenet Grp, Newcastle Upon Tyne, England

[6] United Kingdom Acute Lymphoblast Leukaemia UKALL S, Liverpool, England

[7] Great Ormond St Hosp Sick Children, Dept Haematol, London WC1N 3JH, England

[8] Hannover Med Sch, Dept Paediat Haematol & Oncol, D-30625 Hannover, Germany

[9] Berlin Frankfurt Munster Study Grp BFM, Frankfurt, Germany

[10] Univ Med Ctr Schleswig Holstein, Dept Paediat, Kiel, Germany

[11] Univ Milano Bicocca, Dept Pediat, Monza, Italy

[12] Assoc Italiana Ematol & Oncol Pediat AIEOP, Bologna, Italy

[13] Univ Med Ctr Hamburg Eppendorf, Dept Pediat Hematol & Oncol, Hamburg, Germany

[14] Childhood Acute Lymphoblast Leukemia Study Grp CoA, Hamburg, Germany

[15] Charles Univ Prague, Fac Med 2, Dept Pediat Hematol & Oncol, Prague, Czech Republic

[16] Niigata Univ, Dept Pediat, Grad Sch Med & Dent Sci, Niigata, Japan

[17] Childrens Canc & Leukemia Study Grp CCLSG, Nagoya, Japan

[18] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Pediat, Kyoto, Japan

[19] Japan Childhood Leukemia Study Grp JACLS, Nagoya, Japan

[20] Karolinska Inst, Dept Womens & Childrens Hlth, Childhood Canc Res Unit, Stockholm, Sweden

[21] Karolinska Univ Hosp, Dept Paediat Oncol, Stockholm, Sweden

[22] Nord Soc Paediat Haematol & Oncol NOPHO, Uppsala, Sweden

[23] Univ Hosp Rigshosp, Univ Copenhagen, Dept Pediat & Adolescent Med, Inst Clin Med,Fac Med, Copenhagen, Denmark

[24] Nord Soc Paediat Haematol & Oncol NOPHO, Uppsala, Sweden

来源：

LEUKEMIA | 2024年 / 38卷 / 07期

关键词：

MINIMAL RESIDUAL DISEASE; TRIAL AIEOP-BFM; L-ASPARAGINASE; DELAYED INTENSIFICATION; INTENSIVE CHEMOTHERAPY; PROGNOSTIC-FACTORS; DOSE INTENSITY; CHILDHOOD; CHILDREN; REDUCTION;

D O I：

10.1038/s41375-024-02287-7

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Recent trials show 5-year survival rates >95% for ETV6::RUNX1 Acute Lymphoblastic Leukemia (ALL). Since treatment has many side effects, an overview of cumulative drug doses and intensities between eight international trials is presented to characterize therapy needed for cure. A meta-analysis was performed as a comprehensive summary of survival outcomes at 5 and 10 years. For drug dose comparison in non-high risk trial arms, risk group distribution was applied to split the trials into two groups: trial group A with similar to 70% (range: 63.5-75%) of patients in low risk (LR) (CCLSG ALL2004, CoALL 07-03, NOPHO ALL2008, UKALL2003) and trial group B with similar to 45% (range: 38.7-52.7%) in LR (AIEOP-BFM ALL 2000, ALL-IC BFM ALL 2002, DCOG ALL10, JACLS ALL-02). Meta-analysis did not show evidence of heterogeneity between studies in trial group A LR and medium risk (MR) despite differences in treatment intensity. Statistical heterogeneity was present in trial group B LR and MR. Trials using higher cumulative dose and intensity of asparaginase and pulses of glucocorticoids and vincristine showed better 5-year event-free survival but similar overall survival. Based on similar outcomes between trials despite differences in therapy intensity, future trials should investigate, to what extent de-escalation is feasible for ETV6::RUNX1 ALL.

引用

页码：1477 / 1487

页数：11

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