Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Meeting Report
  • Published:

The Seventh International Childhood Acute Lymphoblastic Leukemia Workshop Report: Palermo, Italy, January 29–30, 2005

Abstract

Between 1995 and 2004, six International Childhood Acute Lymphoblastic Leukemia (ALL) Workshop have been held, and the completion of several collaborative projects has established the clinical relevance and treatment options for several specific genetic subtypes of ALL. This meeting report summarizes the data presented in the seventh meeting and the discussion.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Pui CH, Evans WE, Gilbert JR . Meeting report: International Childhood ALL Workshop: Memphis, TN, 3–4 December 1997. Leukemia 1995; 12: 1313–1318.

    Article  Google Scholar 

  2. Pui CH, Sallan S, Relling MV, Masera G, Evans WE . International Childhood Acute Lymphoblastic Leukemia Workshop: Sausalito, CA, 30 November–1 December 2000. Leukemia 2001; 15: 707–715.

    Article  CAS  Google Scholar 

  3. Gadner H, Haas OH, Masera G, Pui C-H, Schrappe M . ‘Ponte di Legno’ Working Group – Report on the Fifth International Childhood Acute Lymphoblastic Leukemia Workshop: Vienna, Austria, 29 April–1 May 2002. Leukemia 2003; 17: 798–803.

    Article  CAS  Google Scholar 

  4. Pui C-H, Schrappe M, Masera G, Nachman J, Gadner H, Eden OB et al. Ponte di Legno Working Group: statement on the right of children with leukemia to have full access to essential treatment and report on the Sixth International Childhood Acute Lymphoblastic Leukemia Workshop. Leukemia 2004; 18: 1043–1053.

    Article  Google Scholar 

  5. Pui C-H, Relling MV, Downing JR . Acute lymphoblastic leukemia. N Engl J Med 2004; 350: 1535–1548.

    Article  CAS  Google Scholar 

  6. Childhood ALL Collaborative Group. Duration and intensity of maintenance chemotherapy in acute lymphoblastic leukaemia: overview of 42 trials involving 12?000 randomised children. Lancet 1999; 347: 1783–1788.

  7. Lange BJ, Bostrom BC, Cherlow JM, Sensel MG, La MKL, Rackoff W et al. Double-delayed intensification improves event-free survival for children with intermediate-risk acute lymphoblastic leukemia: a report from the Children's Cancer Group. Blood 2002; 99: 825–833.

    Article  CAS  Google Scholar 

  8. Campana D . Determination of minimal residual disease in leukaemia patients. Br J Haematol 2003; 121: 823–838.

    Article  Google Scholar 

  9. Szczepanski T, Orfao A, van der Velden VH, San Miguel JF, Van Dongen JJ . Minimal residual disease in leukaemia patients. Lancet Oncol 2001; 2: 409–417.

    Article  CAS  Google Scholar 

  10. Cazzaniga G, Biondi A . Molecular monitoring of minimal residual disease. In: Pui C-H (ed). Treatment of Acute Leukemias: New Directions for Clinical Research. Tototwa, NJ: Humana Press, 2003, pp 537–547.

    Google Scholar 

  11. Cazzaniga G, Biondi A . Molecular monitoring of childhood acute lymphoblastic leukemia using antigen receptor gene rearrangements and quantitative polymerase chain reaction technology. Haematologica 2005; 90: 382–390.

    CAS  Google Scholar 

  12. Pui C-H, Campana D . New definition of remission in childhood acute lymphoblastic leukemia. Leukemia 2000; 14: 783–785.

    Article  CAS  Google Scholar 

  13. Borowitz MJ, Pullen DJ, Shuster JJ, Viswanatha D, Montgomery K, Willman CL et al. Minimal residual disease detection in childhood precursor-B-cell acute lymphoblastic leukemia: relation to other risk factors. A Children's Oncology Group study. Leukemia 2003; 17: 1566–1572.

    Article  CAS  Google Scholar 

  14. Malec M, van der Velden VHJ, Björklund E, Wijkhuijs JM, Söderhäll S, Mazur J et al. Analysis of minimal residual disease in childhood acute lymphoblastic leukemia: comparison between RQ-PCR analysis of Ig/TcR gene rearrangements and multicolor flow cytometric immunophenotyping. Leukemia 2004; 18: 1630–1636.

    Article  CAS  Google Scholar 

  15. Coustan-Smith E, Gajjar A, Hijiya N, Razzouk BI, Ribeiro RC, Rivera GK et al. Clinical significance of minimal residual disease in childhood acute lymphoblatsic leukemia after first relapse. Leukemia 2004; 18: 499–504.

    Article  CAS  Google Scholar 

  16. Bostrom BC, Sensel MR, Sather HN, Gaynon PS, La MK, Johnston K et al. Dexamethasone vs prednisone and daily oral vs weekly intravenous mercaptopurine for patients with standard-risk acute lymphoblastic leukemia: a report from the Children's Cancer Group. Blood 2003; 101: 3809–3817.

    Article  CAS  Google Scholar 

  17. Igarashi S, Manabe A, Ohara A, Kumagai M, Saito T, Okimoto Y et al. No advantage of dexamethasone over prednisolone for the outcome of standard and intermediate risk childhood acute lymphoblastic leukemia in the Tokyo Children's Cancer Study Group L95-14 protocol. J Clin Oncol (in press).

  18. Mitchell CD, Richards SM, Kinsey SE, Lilleymann J, Vora AJ, Eden TOB . Benefit of dexamethasone compared with prednisolone for childhood acute lymphoblastic leukaemia: results of the UK Medical research Council ALL 97/99 trial. Br J Haematol 2005 (in press).

  19. Clarke M, Gaynon P, Hann I, Harrison G, Masera G, Peto R et al. CNS-directed therapy for childhood acute lymphoblastic leukemia: childhood ALL collaborative group overview of 43 randomized trials. J Clin Oncol 2003; 21: 1798–1809.

    Article  CAS  Google Scholar 

  20. Nachman JB, Sather HN, Sensel MG, Trigg ME, Cherlow JM, Lukens JN et al. Augmented post-induction therapy for children with high-risk acute lymphoblastic leukemia and a slow response to initial therapy. N Engl J Med 1998; 338: 1663–1671.

    Article  CAS  Google Scholar 

  21. Sallan SE, Gelber RD, Kimball V, Donnelly M, Cohen HJ . More is better! Update of Dana-Farber Cancer Institute/Children's Hospital acute lymphoblastic leukemia trials. Haematol Blood Transfus 1990; 33: 459–466.

    CAS  PubMed  Google Scholar 

  22. van der Does-van den Berg A, van Wering ER, Suciu S, Solbu G, van’t Veer MB, Rammeloo JA et al. Effectiveness of rubidomycin in induction therapy with vincristine, prednisone, and L-asparaginase for standard risk childhood acute lymphocytic leukemia: results of a Dutch phase III study (ALL V). A report on behalf of the Dutch Childhood Leukemia Study Group (DCLSG). Am J Pediatr Hematol Oncol 1989; 11: 125–133.

    CAS  PubMed  Google Scholar 

  23. Eden OB, Lilleyman JS, Richards S, Shaw MP, Peto J . Results of Medical Research Council Childhood Leukaemia Trial UKALL VIII (Report to the Medical Research Council on behalf of the Working Party on Leukaemia in Childhood). Br J Haematol 1991; 78: 187–196.

    Article  CAS  Google Scholar 

  24. Hargrave DR, Hann IM, Richards SR, Hill FG, Lilleyman JS, Kinsey S et al. Progressive reduction in treatment-related deaths in Medical Research Council childhood lymphoblastic leukaemia trials from 1980 to 1997 (UKALL VIII, X and XI). Br J Haematol 2001; 112: 293–299.

    Article  CAS  Google Scholar 

  25. Tubergen D, Gilchrist G, O’Brien A, Coccia P, Sather H, Waskerwitz M et al. Improved outcome with delayed intensification for children with acute lymphoblastic leukemia and intermediate presenting features. J Clin Oncol 1993; 11: 527–537.

    Article  CAS  Google Scholar 

  26. Lipshultz SE, Giantris AL, Lipsitz SR, Kimball Dalton V, Asselin BL, Barr RD et al. Doxorubicin administration by continuous infusion is not cardioprotective: the Dana-Farber 91-01 Acute Lymphoblastic Leukemia protocol. J Clin Oncol 2002; 20: 1677–1682.

    Article  CAS  Google Scholar 

  27. Harms DO, Janka-Schaub GE . Co-operative study group for childhood acute lymphoblastic leukemia (COALL): long-term follow-up of trials 82, 85, 89 and 92. Leukemia 2000; 14: 2234–2239.

    Article  CAS  Google Scholar 

  28. Lipshultz SE, Rifai N, Dalton VM, Levy DE, Silverman LB, Lipsitz SR et al. The effect of dexrazoxane on myocardial injury in doxorubicin-treated children with acute lymphoblastic leukemia. N Engl J Med 2004; 351: 145–153.

    Article  CAS  Google Scholar 

  29. Lipshultz SE, Rifai N, Sallan SE, Lipsitz SR, Dalton V, Sacks DB et al. Predictive value of cardiac troponin T in pediatric patients at risk for myocardial injury. Circulation 1997; 96: 2641–2648.

    Article  CAS  Google Scholar 

  30. Schmiegelow K, Glomstein A, Kristinsson J, Salmi T, Schrøder H, Björk O . On behalf of the Nordic Society for Pediatric Hematology and Oncology. Influence of circadian schedule and of food on the pharmacokinetics of methotrexate and 6-mercaptopurine and on relapse risk in childhood acute lymphoblastic leukemia. J Pediatr Hematol Oncol 1997; 19: 102–109.

    Article  CAS  Google Scholar 

  31. Nygaard U, Toft N, Schmiegelow K . Methylated metabolites of 6-mercaptopurine are associated with hepatotoxicity in childhood leukaemia. Clin Pharmacol Ther 2004; 75: 274–281.

    Article  CAS  Google Scholar 

  32. Toyoda Y, Manabe A, Tsuchida M, Hanada R, Ikuta K, Okimoto Y et al. Six months of maintenance chemotherapy alter intensified treatment for acute lymphoblastic leukemia of childhood. J Clin Oncol 2000; 18: 1508–1516.

    Article  CAS  Google Scholar 

  33. Schrappe M, Reiter A, Zimmermann M, Harbott J, Ludwig WD, Henze G et al. Long-term results of four consecutive trials in childhood ALL performed by the ALL-BFM study group from 1981 to 1995. Leukemia 2000; 14: 2205–2222.

    Article  CAS  Google Scholar 

  34. Childhood ALL Collaborative Group. Duration and intensity of maintenance chemotherapy in acute lymphoblastic leukaemia: overview of 42 trials involving 12?000 randomised children. Lancet 1996; 347: 1783–1788.

  35. Tubergen DG, Gilchrist GS, O’Brien RT, Coccia PF, Sather HN, Waskerwitz MJ et al. Prevention of CNS disease in intermediate risk acute lymphoblastic leukemia: comparison of cranial radiation and intrathecal methotrexate and the importance of systemic therapy: a Children Cancer Group report. J Clin Oncol 1993; 11: 520–526.

    Article  CAS  Google Scholar 

  36. Pullen J, Boyett J, Shuster J, Crist W, Land V, Frankel L et al. Extended triple intrathecal chemotherapy trial for prevention CNS relapse in good-risk and poor-risk patients with B-progenitor acute lymphoblastic leukaemia: a Pediatric Oncology Group study. J Clin Oncol 1993; 11: 839–849.

    Article  CAS  Google Scholar 

  37. Conter V, Aricò M, Valsecchi MG, Rizzari C, Testi AM, Messina C et al. Extended intrathecal methotrexate may replace cranial irradiation for prevention of CNS relapse in children with intermediate-risk acute lymphoblastic leukemia treated with BFM intensive chemotherapy. J Clin Oncol 1995; 13: 2497–2502.

    Article  CAS  Google Scholar 

  38. Hvizdala E, Berry DH, Chen T, Dyment PG, Kim TH, Steuber CP et al. Impact of the timing of triple intrathecal therapy on remission induction in childhood acute lymphoblastic leukemia: a Pediatric Oncology Group study. Med Pediatr Oncol 1984; 12: 173–177.

    Article  CAS  Google Scholar 

  39. Pullen J, Boyett J, Shuster J, Crist W, Land V, Frankel L et al. Extended triple intrathecal chemotherapy trial for prevention of CNS relapse in good-risk and poor-risk patients with B-progenitor acute lymphoblastic leukemia: a Pediatric Oncology Group study. J Clin Oncol 1993; 11: 839–849.

    Article  CAS  Google Scholar 

  40. Pui CH, Sandlund JT, Pei D, Campana D, Rivera GK, Ribeiro RC et al. Improved outcome for children with acute lymphoblastic leukemia: results of Total Therapy Study XIIIB at St Jude Children's Research Hospital. Blood 2004; 104: 2690–2696.

    Article  CAS  Google Scholar 

  41. Grindey GB, Nichol CA . Interaction of drugs inhibiting different steps in the synthesis of DNA. Cancer Res 1972; 32: 527–531.

    CAS  PubMed  Google Scholar 

  42. Tattersall MH, Harrap KR . Combination chemotherapy: the antagonism of MTX and Ara-C. Eur J Cancer 1973; 9: 229–232.

    Article  CAS  Google Scholar 

  43. Edelstein M, Vietti T, Valeriotte F . The enhanced cytotoxicity of combinations of 1-beta-D-arabinofuranosylcytosine and methotrexate. Cancer Res 1975; 35: 1555–1558.

    CAS  PubMed  Google Scholar 

  44. Akutsu M, Furukawa Y, Tsunoda S, Izumi T, Ohmine K, Kano Y . Schedule-dependent synergism and antagonism between methotrexate and cytarabine against human cell lines in vitro. Leukemia 2002; 16: 1808–1817.

    Article  CAS  Google Scholar 

  45. Neuwelt EA, Barnett PA, Bigner DD, Frenkel EP . Effects of adrenal cortical steroids and osmotic blood–brain barrier opening on methotrexate delivery to gliomas in the rodent: the factor of the blood brain–brain barrier. Proc Natl Acad Sci USA 1982; 79: 4420–4423.

    Article  CAS  Google Scholar 

  46. Bostrom B, Erdman GR, Kamen BA . Systemic methotrexate exposure is greater after intrathecal than after oral administration. J Pediatr Hematol Oncol 2003; 25: 114–117.

    Article  Google Scholar 

  47. Gregory RE, Pui C-H, Crom WR . Raised plasma methotrexate concentrations following intrathecal administration in children with renal dysfunction. Leukemia 1991; 5: 999–1003.

    CAS  PubMed  Google Scholar 

  48. Thyss A, Suciu S, Bertrand Y, Mazingue F, Robert A, Vilmer E et al. Systemic effect of intrathecal methotrexate during the initial phase of treatment of childhood acute lymphoblastic leukemia. The European Organization for Research and Treatment of Cancer Children's Leukemia Cooperative Group. J Clin Oncol 1997; 15: 1824–1830.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported in part by the Osterreichische Kinderkrebshilfe and private donations to the Children's Cancer Research Institute; the Associazione Italiana Ricerca sul Cancro, Fondazione Tettamanti, and Consiglio Nazionale Ricerche-Ministero Istruzione Universitá Ricerca; the Deutsche Krebshilfe, Bonn, and Madeleine Schickedanz Foundation, Fürth, Germany; Cancer Research UKJ; grants from the US National Institutes of Health (CA-21765, CA-51001, CA-31566, CA-78824, CA-29139, CA-37379, GM-61393, and GM61374), a Center of Excellence grant from the State of Tennessee, and the American Lebanese Syrian Associated Charities (ALSAC). C-H Pui is the American Cancer Society-FM Kirby Clinical Research Professor and Tim Eden the Cancer Research (UK) Professor of Paediatric Oncology.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M Aricó.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aricó, M., Baruchel, A., Bertrand, Y. et al. The Seventh International Childhood Acute Lymphoblastic Leukemia Workshop Report: Palermo, Italy, January 29–30, 2005. Leukemia 19, 1145–1152 (2005). https://doi.org/10.1038/sj.leu.2403783

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.leu.2403783

Keywords

This article is cited by

Search

Quick links