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Acute Leukemias

Long-term follow-up of the United Kingdom medical research council protocols for childhood acute lymphoblastic leukaemia, 1980–2001

Leukemia volume 24, pages 406–418 (2010)Cite this article

Abstract

Between 1980 and 2001, the United Kingdom Medical Research Council Childhood Leukemia Working Party conducted four clinical trials in acute lymphoblastic leukaemia (ALL), which recruited a total of 6516 patients. UKALL VIII examined the role of daunorubicin in induction chemotherapy, and UKALL X examined the role of post-induction intensification. Both resulted in major improvement in the outcomes. UKALL XI examined the efficacy of different methods of central nervous system-directed therapy and the effects of an additional intensification. ALL97, which was initially based on the UKALL XD template (two intensification phases), examined the role of different steroids in induction and of different thiopurines through continuing chemotherapy. A reappraisal of results from UKALL XI compared with other cooperative group results led to a redesign in 1999, which subsequently resulted in a major improvement in outcomes. In addition, ALL97 and ALL97/99 showed a significant advantage for the use of dexamethasone rather than prednisolone; although the use of 6-thioguanine resulted in fewer relapses, this advantage was offset by an increased incidence of deaths in remission. Over the era encompassed by these four trials, there has been a major improvement in both event-free and overall survival for children in the United Kingdom with ALL.

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Acknowledgements

The authors acknowledge the many co-investigators who contributed to the design, conduct and previous reporting of the four trials that are the subject of this updated report. This work was supported by Medical Research Council grant number G8223452.

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Authors and Affiliations

  1. Department of Paediatric Haematology/Oncology, John Radcliffe Hospital, Oxford, UK

    C Mitchell

  2. Clinical Trial Service Unit, University of Oxford, Oxford, UK

    S Richards

  3. Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK

    C J Harrison

  4. Teenage and Young Adult Unit, Christie Hospital, Manchester, UK

    T Eden

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Correspondence to C Mitchell.

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Mitchell, C., Richards, S., Harrison, C. et al. Long-term follow-up of the United Kingdom medical research council protocols for childhood acute lymphoblastic leukaemia, 1980–2001. Leukemia 24, 406–418 (2010). https://doi.org/10.1038/leu.2009.256

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