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Spotlight on Long-Term Results of Pediatric ALL Clinical Trials from 12 Study Groups World Wide

Long-term results of large prospective trials in childhood acute lymphoblastic leukemia

  • M Schrappe1,
  • B Camitta2 &
  • C-H Pui3
  • on behalf of T Eden, P Gaynon, G Gustafsson, Ge Janka-Schaub, W Kamps, G Masera, S Sallan, M Tsuchida and E Vilmer

Leukemia volume 14, pages 2193–2194 (2000)Cite this article

Much progress has been made in the biological characterization of acute lymphoblastic leukemia (ALL). Many biologic features with prognostic significance have been used together with clinical factors to define patient groups for risk-adapted therapy.123 However, it is well recognized that the prognostic significance of virtually all variables depends on the type and intensity of treatment. The differences in risk classification, eligibility (eg upper or lower age limit) and composition of ethnic or racial population have made it difficult to compare results between study groups. The comparison is further complicated by the inclusion of only subsets of patients in some publications.

In October 1985, an international workshop (organized by R Mastrangelo) was held in Rome during which recommendations were made to report study results by common, easily available criteria (age and presenting leukocyte count); to collect prospectively information on organ involvement, immunphenotype, genetics and treatment response; and to use standard statistical methods to analyze data.4 Despite this effort, different risk classifications continue to be used, and a large number of clinical trials had been conducted on subgroups of ALL, especially in the USA. In 1993, the US National Cancer Institute organized a workshop for the US cooperative study groups and major institutions to develop uniform risk criteria. The recommendations published in 19965 were more widely accepted. The major groups defined by age and leukocyte count were identical to that of the Rome workshop (Table 1). While the importance of cytogenetics and molecular genetics were recognized, they were not included in the risk criteria because the tests were not widely available at that time. The criteria also did not include early treatment response. Finally, the classification criteria were not optimal for T cell ALL.6

Table 1  Proportion of standard- and high-risk ALL based on the NCI/Rome criteria by leukemia cell lineage
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Authors and Affiliations

  1. Medizinische Hochschule, Ped Hematology/Oncology, Hannover, Germany

    M Schrappe

  2. Medical College of Wisconsin, Pediatric Hematology/Oncology, Milwaukee, WI, USA

    B Camitta

  3. St Jude Children's Research Hospital, Memphis, TN, USA

    C-H Pui

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  1. M Schrappe
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  2. B Camitta
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on behalf of T Eden, P Gaynon, G Gustafsson, Ge Janka-Schaub, W Kamps, G Masera, S Sallan, M Tsuchida and E Vilmer

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Schrappe, M., Camitta, B., Pui, CH. et al. Long-term results of large prospective trials in childhood acute lymphoblastic leukemia. Leukemia 14, 2193–2194 (2000). https://doi.org/10.1038/sj.leu.2401977

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