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Outcome of relapsed infant acute lymphoblastic leukemia treated on the interfant-99 protocol

Leukemia volume 30, pages 1184–1187 (2016)Cite this article

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A Corrigendum to this article was published on 06 December 2017

Acute lymphoblastic leukemia (ALL) in infants (<1 year of age) is an aggressive disease. About 80% of infant ALL patients harbor a mixed lineage leukemia (MLL) translocation, which is a strong independent predictor of poor outcome.1 Furthermore, infant ALL is associated with higher white blood cell (WBC) counts at diagnosis, very immature pro-B ALL phenotype and glucocorticoid resistance.1, 2 Although most infant ALL patients (~95%) achieve morphological complete remission (CR) after induction therapy, owing to high relapse-rates their outcome is poor.1 Most relapses occur early, within the first year after diagnosis. The largest series of infant ALL, described by the Interfant-99 study group, reported a relapse rate of 34%. Relapsed infant ALL is generally assumed to be inevitably fatal. Published data on outcome of relapsed infant ALL are very limited, and available ones report on small cohorts.3

Here, we describe the clinical outcome of 202 infant ALL patients, who relapsed on or after receiving the Interfant-99 treatment protocol.1 Design and inclusion criteria of the Interfant-99 trial have been described previously.1 Therapy after relapse differed in participating countries according to local policy and individual choice. We retrospectively asked the physicians whether the therapy was based on curative or palliative intent.

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Author notes

  1. M Valsecchi and R Pieters: These authors contributed equally to this work.

Authors and Affiliations

  1. Pediatric Oncology/Hematology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, the Netherlands

    E M C Driessen & R Pieters

  2. Department of Clinical Medicine and Prevention, Interfant-99 Trial Data Center, University of Milano-Bicocca, Monza, Italy

    P de Lorenzo & M Valsecchi

  3. Chilean National Pediatric Oncology Group, PINDA, Roberto del Rio Hospital, Universidad de Chile, Santiago, Chile

    M Campbell

  4. Department of Pediatric Hematology/Oncology, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina

    M Felice

  5. Department of Hemato-Oncology, Hôpital Unviversitaire des Enfants Reine Fabiola (ULB), Brussels, Belgium

    A Ferster

  6. UK Children's Cancer Study Group, Great Ormond Street Hospital for Children, London, UK

    I Hann

  7. Department of Paediatric Haematology, Sheffield Children's Hospital, Sheffield, UK

    A Vora

  8. Nordic Society of Paediatric Haematology and Oncology, University of Helsinki, Helsinki, Finland

    L Hovi

  9. University Medical Center Hamburg-Eppendorf, Clinic of Pediatric Hematology and Oncology, Hamburg, Germany

    G Escherich

  10. Hong Kong Paediatric Haematology and Oncology Study Group, Prince of Wales Hospital, Hong Kong, China

    C K Li

  11. Department of Pediatrics, St. Anna Children's Cancer Research Institute and St. Anna Children's Hospital, Medical University School, Vienna, Austria

    G Mann

  12. Departement of Pediatric Hematology, Hôpital Robert-Debré, Paris, fort he FRALLE group, Paris, France

    T Leblanc

  13. Associazione Italiana Ematologia Oncologia Pediatrica, Italy Bambino Gesù Children’s Hospital, Rome, Italy

    F Locatelli & A Biondi

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

    J Rubnitz

  15. Berlin-Frankfurt-Münster Study Group, Hannover, Germany

    M Schrappe

  16. Dana-Farber Cancer Institute ALL Consortium, Boston, MA, USA

    L Silverman

  17. Czech Pediatric Haematology, Prague, Czech Republic

    J Stary

  18. Australian and New Zealand Children's Haematology and Oncology Study Group, North Adelaide, Australia

    R Suppiah

  19. and Department of Pediatric Hematology and Oncology, Polish Pediatric Leukemia and Lymphoma Study Group, Zabrze, Medical University of Silesia, Katowice, Poland

    T Szczepanski

  20. Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands

    R Pieters

  21. Dutch Childhood Oncology Group, The Hague, the Netherlands

    R Pieters

Authors
  1. E M C Driessen
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  2. P de Lorenzo
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  3. M Campbell
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  4. M Felice
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  5. A Ferster
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  6. I Hann
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  7. A Vora
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  8. L Hovi
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  9. G Escherich
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  10. C K Li
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  11. G Mann
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  13. F Locatelli
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  14. A Biondi
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  15. J Rubnitz
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  16. M Schrappe
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  17. L Silverman
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  18. J Stary
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  19. R Suppiah
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  21. M Valsecchi
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  22. R Pieters
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Corresponding author

Correspondence to R Pieters.

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The authors declare no conflict of interest.

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Author contributions

EMCD analyzed the data and wrote paper. PdL, MGV collected patient characteristics and performed the statistical analysis, analyzed the data and wrote the paper. MC, MF, AF, IH, AV, LH, GE, CKL, GM, TLB, FL, AB, JR, MS LS, JS, RS, TS collected the data, commented on and approved the final version of the manuscript. RP supervised the study, analyzed the data and wrote the manuscript.

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Driessen, E., de Lorenzo, P., Campbell, M. et al. Outcome of relapsed infant acute lymphoblastic leukemia treated on the interfant-99 protocol. Leukemia 30, 1184–1187 (2016). https://doi.org/10.1038/leu.2015.246

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