Abstract
ER+ T cell ALL is characterized by widespread extramedullary disease and early relapse when standard forms of therapy are used (ER+ defined as >40% bone marrow blasts forming rosettes with sheep erythrocytes at 4°C). One hundred forty-five children with ER+ T cell ALL received either of two intensive multiagent sequential therapy protocols ± multimodal CNS prophylaxis. Overall outcome was equal to or superior to reported results from other large series of similar patients. However, patterns of extramedullary relapse differed by treatment group (1=modified LSA2, L2; 2=1 plus multimodal CNS therapy; 3 included multimodal CNS therapy but utilized limited asparaginase and no BCNU or Hydroxyurea):
The logrank comparison (three-way) for relapse at any site was p=.74 and for marrow relapse was p=.15. The comparison (two-way) for CNS relapse between treatment 1 vs. 2+3 (two-sided) was p=.006, and in males for testicular relapse between 1+2 vs. 3 was p=.048. The marrow remains the major site of relapse for these patients.
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Falletta, J., Pullen, D., Shuster, J. et al. 904 E-Rosette Positive (ER+), T Antigen Positive (T cell) Acute Lymphocytic Leukemia (ALL)-Patterns of Relapse. Pediatr Res 19, 261 (1985). https://doi.org/10.1203/00006450-198504000-00934
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DOI: https://doi.org/10.1203/00006450-198504000-00934