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Results of successive EORTC-CLG 58 881 and 58 951 trials in paediatric T-cell acute lymphoblastic leukaemia (ALL)

Mattias Hofmans (UGent) , Stefan Suciu, Alina Ferster, Pieter Van Vlierberghe (UGent) , Françoise Mazingue, Nicolas Sirvent, Vitor Costa, Karima Yakouben, Catherine Paillard, Anne Uyttebroeck, et al.
(2019) BRITISH JOURNAL OF HAEMATOLOGY. 186(5). p.741-753
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Abstract
Outcomes in childhood T-cell acute lymphoblastic leukaemia (T-ALL) are steadily improving due to intensive therapy. Between 1989 and 2008, 599 children with newly diagnosed T-ALL were enrolled in two successive European Organization for Research and Treatment of Cancer - Children's Leukaemia Group trials (58881 and 58951), both based on the Berlin-Frankfurt-Munster protocol and without cranial irradiation. In the latter trial induction chemotherapy was intensified. The most important randomizations were Medac Escherichia coli asparaginase versus Erwinia asparaginase in trial 58881, and dexamethasone (6 mg/m(2)/day) versus prednisolone (60 mg/m(2)/day) and prolonged versus conventional asparaginase duration in trial 58951. 8-year event-free survival (EFS) increased from 65 center dot 1% to 74 center dot 0% in trial 58951. Improvement was most profound for patients with white blood cell (WBC) counts E. coli asparaginase was associated with longer EFS [hazard ratio (HR) 0 center dot 54, P = 0 center dot 0015] and overall survival (HR 0 center dot 51, P = 0 center dot 0018). Induction therapy with dexamethasone did not improve EFS compared to prednisolone. Remarkably, intensification of central nervous system (CNS)-directed therapy in trial 58951 resulted in fewer bone marrow relapses, while the incidence of CNS relapses remained low. In summary, we showed that adequate asparaginase therapy, intensified induction treatment and intensification of CNS-directed chemotherapy can result in an improvement of outcome in T-ALL patients with good prephase response and initial WBC counts <100 x 10(9)/l, representing approximately 50% of T-ALL patients.
Keywords
T-cell acute lymphoblastic leukaemia, EORTC, childhood leukaemia, asparaginase, cranial radiotherapy, ESCHERICHIA-COLI-ASPARAGINASE, TREATMENT-OF-CANCER, CRANIAL RADIATION, INDUCTION THERAPY, AIEOP-BFM, CHILDHOOD, CHILDREN, RISK, DEXAMETHASONE, PREDNISOLONE

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MLA
Hofmans, Mattias, et al. “Results of Successive EORTC-CLG 58 881 and 58 951 Trials in Paediatric T-Cell Acute Lymphoblastic Leukaemia (ALL).” BRITISH JOURNAL OF HAEMATOLOGY, vol. 186, no. 5, 2019, pp. 741–53.
APA
Hofmans, M., Suciu, S., Ferster, A., Van Vlierberghe, P., Mazingue, F., Sirvent, N., … De Moerloose, B. (2019). Results of successive EORTC-CLG 58 881 and 58 951 trials in paediatric T-cell acute lymphoblastic leukaemia (ALL). BRITISH JOURNAL OF HAEMATOLOGY, 186(5), 741–753.
Chicago author-date
Hofmans, Mattias, Stefan Suciu, Alina Ferster, Pieter Van Vlierberghe, Françoise Mazingue, Nicolas Sirvent, Vitor Costa, et al. 2019. “Results of Successive EORTC-CLG 58 881 and 58 951 Trials in Paediatric T-Cell Acute Lymphoblastic Leukaemia (ALL).” BRITISH JOURNAL OF HAEMATOLOGY 186 (5): 741–53.
Chicago author-date (all authors)
Hofmans, Mattias, Stefan Suciu, Alina Ferster, Pieter Van Vlierberghe, Françoise Mazingue, Nicolas Sirvent, Vitor Costa, Karima Yakouben, Catherine Paillard, Anne Uyttebroeck, Dominique Plantaz, Geneviève Plat, Pauline Simon, Frédéric Millot, Marilyne Poirée, Jutte van der Werff ten Bosch, Caroline Piette, Odile Minckes, Pierre Rohrlich, Sandrine Girard, Hélène Cavé, Yves Bertrand, and Barbara De Moerloose. 2019. “Results of Successive EORTC-CLG 58 881 and 58 951 Trials in Paediatric T-Cell Acute Lymphoblastic Leukaemia (ALL).” BRITISH JOURNAL OF HAEMATOLOGY 186 (5): 741–753.
Vancouver
1.
Hofmans M, Suciu S, Ferster A, Van Vlierberghe P, Mazingue F, Sirvent N, et al. Results of successive EORTC-CLG 58 881 and 58 951 trials in paediatric T-cell acute lymphoblastic leukaemia (ALL). BRITISH JOURNAL OF HAEMATOLOGY. 2019;186(5):741–53.
IEEE
[1]
M. Hofmans et al., “Results of successive EORTC-CLG 58 881 and 58 951 trials in paediatric T-cell acute lymphoblastic leukaemia (ALL),” BRITISH JOURNAL OF HAEMATOLOGY, vol. 186, no. 5, pp. 741–753, 2019.
@article{8617420,
  abstract     = {Outcomes in childhood T-cell acute lymphoblastic leukaemia (T-ALL) are steadily improving due to intensive therapy. Between 1989 and 2008, 599 children with newly diagnosed T-ALL were enrolled in two successive European Organization for Research and Treatment of Cancer - Children's Leukaemia Group trials (58881 and 58951), both based on the Berlin-Frankfurt-Munster protocol and without cranial irradiation. In the latter trial induction chemotherapy was intensified. The most important randomizations were Medac Escherichia coli asparaginase versus Erwinia asparaginase in trial 58881, and dexamethasone (6 mg/m(2)/day) versus prednisolone (60 mg/m(2)/day) and prolonged versus conventional asparaginase duration in trial 58951. 8-year event-free survival (EFS) increased from 65 center dot 1% to 74 center dot 0% in trial 58951. Improvement was most profound for patients with white blood cell (WBC) counts E. coli asparaginase was associated with longer EFS [hazard ratio (HR) 0 center dot 54, P = 0 center dot 0015] and overall survival (HR 0 center dot 51, P = 0 center dot 0018). Induction therapy with dexamethasone did not improve EFS compared to prednisolone. Remarkably, intensification of central nervous system (CNS)-directed therapy in trial 58951 resulted in fewer bone marrow relapses, while the incidence of CNS relapses remained low. In summary, we showed that adequate asparaginase therapy, intensified induction treatment and intensification of CNS-directed chemotherapy can result in an improvement of outcome in T-ALL patients with good prephase response and initial WBC counts <100 x 10(9)/l, representing approximately 50% of T-ALL patients.},
  author       = {Hofmans, Mattias and Suciu, Stefan and Ferster, Alina and Van Vlierberghe, Pieter and Mazingue, Françoise and Sirvent, Nicolas and Costa, Vitor and Yakouben, Karima and Paillard, Catherine and Uyttebroeck, Anne and Plantaz, Dominique and Plat, Geneviève and Simon, Pauline and Millot, Frédéric and Poirée, Marilyne and van der Werff ten Bosch, Jutte and Piette, Caroline and Minckes, Odile and Rohrlich, Pierre and Girard, Sandrine and Cavé, Hélène and Bertrand, Yves and De Moerloose, Barbara},
  issn         = {0007-1048},
  journal      = {BRITISH JOURNAL OF HAEMATOLOGY},
  keywords     = {T-cell acute lymphoblastic leukaemia,EORTC,childhood leukaemia,asparaginase,cranial radiotherapy,ESCHERICHIA-COLI-ASPARAGINASE,TREATMENT-OF-CANCER,CRANIAL RADIATION,INDUCTION THERAPY,AIEOP-BFM,CHILDHOOD,CHILDREN,RISK,DEXAMETHASONE,PREDNISOLONE},
  language     = {eng},
  number       = {5},
  pages        = {741--753},
  title        = {Results of successive EORTC-CLG 58 881 and 58 951 trials in paediatric T-cell acute lymphoblastic leukaemia (ALL)},
  url          = {http://dx.doi.org/10.1111/bjh.15983},
  volume       = {186},
  year         = {2019},
}
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