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Long-term results of three randomized trials (58831, 58832, 58881) in childhood acute lymphoblastic leukemia: a CLCG-EORTC report

Leukemia volume 14, pages 2257–2266 (2000)Cite this article

Abstract

We present here the long-term results of three randomized clinical trials conducted on children with newly diagnosed acute lymphoblastic leukemia (ALL) between 1983 and 1998 by the Children Leukemia Cooperative Group (CLCG) from EORTC. In study 58831/32, the overall event-free survival (EFS) rates (± s.e.) at 6 and 10 years were 66% ± 1.8% and 65% ± 1.8%, respectively, and the risk of isolated central nervous system (CNS) relapse was 6% ± 1% and 7% ± 1%, respectively. In patients with a standard risk of relapse the omission of cyclophosphamide had no adverse effect on disease-free survival rates at 10 years (trial 58831). In medium- and high-risk patients the omission of radiotherapy did not increase the risk of CNS or systemic relapse (trial 58832). In study 58881 (1989–1998) the overall EFS rate at 8 years was 68.4% ± 1.2% and the risk of isolated CNS relapse was 4.2% ± 0.5%. In this trial which adressed three randomized questions, the following results were obtained: the combination of cytarabine at high doses with methotrexate at high doses during interval therapy did not improve prognosis. The addition of 6-mercaptopurine iv during maintenance increased the risk of late relapse. E. coli asparaginase was more toxic and has a higher efficacy than erwinia asparaginase. leukocyte counts >100 × 109/l, specific genetic abnormalities, a poor initial response to steroids or a high level of minimal residual disease at early time points were consistently associated with an adverse prognosis in the 58881 trial.

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Acknowledgements

This publication was supported by grant number 5U10-CA11488–13 through 5U10-CA11488–30 from the National Cancer Institute. Its contents are solely the responsibility of the authors and do not represent the official views of the National Cancer Institute.

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Author notes

  1. E Vilmer and S Suciu: The first two authors contributed equally to this paper

Authors and Affiliations

  1. Department of Hemato-Immunology, Robert Debré Hospital, Paris, France

    E Vilmer

  2. European Organisation for Research and Treatment of Cancer (EORTC), Data Center, Brussels, Belgium

    S Suciu, C Waterkeyn & G Solbu

  3. Department of Hemato-Oncology, HUDE, Brussels, Belgium

    A Ferster

  4. Department of Immuno-Hemato-Pediatry, Debrousse Hospital, Lyon, France

    Y Bertrand, G Souillet & N Philippe

  5. Laboratory of Genetic Biochemistry, Robert Debré Hospital, Paris, France

    H Cavé

  6. Department of Hemato-Oncology, A Lacasagne Center, Nice, France

    A Thyss

  7. Department of Pediatric Hemato-Oncology, Universitair Ziekenhuis, Gent, Belgium

    Y Benoit & G Laureys

  8. Laboratory of Hematology, CHU Purpan, Toulouse, France

    N Dastugue

  9. Laboratory of Hematology, CHR, Lille, France

    M Fournier

  10. Laboratory of Hematology, Debrousse Hospital, Lyon, France

    A-M Manel

  11. Department of Hematology, Children's Hospital, Toulouse, France

    A Robert

  12. Department of Hematology, CHR, Lille, France

    B Nelken

  13. Department of Hematology, J Bernard Hospital, Poitiers, France

    F Millot

  14. Department of Hematology, Hautepierre, Strasbourg, France

    P Lutz

  15. Department of Hematology, CHU, Angers, France

    X Rialland

  16. Department of Hematology, CHR Hotel-Dieu, Nantes, France

    F Mechinaud

  17. Department of Hematology, CHRU, Caen, France

    P Boutard

  18. Department of Hematology, American Hospital, Reims, France

    C Behar

  19. Department of Pediatry, CHR La Citadelle, Liège, Belgium

    J-M Chantraine

  20. Department of Hematology, Saint Jacques Hospital, Besançon, France

    E Plouvier

  21. Department of Pediatrics, UZ Gasthuisberg, Leuven, Belgium

    P Brock & A Uyttebroeck

  22. Department of Onco-Hematology, A Villeneuve Hospital, Montpellier, France

    G Margueritte

  23. Department of Pediatrics, CHR La Tronche, Grenoble, France

    D Plantaz

  24. Department of Pediatrics, Escolar San Joao Hospital, Porto, Portugal

    L Norton

  25. Department of Pediatrics, Esperance Clinic, Montegnée, Belgium

    N Francotte

  26. Department of Pediatrics, AZ Middelheim, Antwerpen, Belgium

    J Gyselinck

  27. Department of Pediatrics, AZ-VUB, Brussels, Belgium

    J Otten

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  1. E Vilmer
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Vilmer, E., Suciu, S., Ferster, A. et al. Long-term results of three randomized trials (58831, 58832, 58881) in childhood acute lymphoblastic leukemia: a CLCG-EORTC report. Leukemia 14, 2257–2266 (2000). https://doi.org/10.1038/sj.leu.2401960

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