Treatment regimens and results for infants with ALL
| Study (year) . | No. of patients . | Event-free survival . | Treatment . | ||||
|---|---|---|---|---|---|---|---|
| Cranial irradiation . | High-dose methotrexate . | High-dose cytarabine . | Consolidation/ reinduction therapy . | Reference . | |||
| AIEOP 88-91 (1988-1995) | 61 | 5-y = 40% | 12-18 Gy if >1 y (6 mo from diagnosis) | 5 g/m2 × 4 doses | — | + | * |
| ATRG (1984-1988) | 24 | 2-y DFS = 20% | all patients | — | — | − | 137 |
| BFM 83 (1983-1086) | 13 | 6-y = 23% ± 12% SE | ±† | — | — | − | 113 |
| BFM 86 (1986-1990) | 34 | 6-y = 37% ± 8% SE | ±† | 5 g/m2 × 4 doses | — | + | 113 |
| BFM 90 (1990-1995) | 59 | 6-y = 51% ± 7% SE | ±† | 5 g/m2 × 4 doses | — | + | 113 |
| CCG 101, 143, 141, 141 A, 162, 163 (1972-1982) | 115 | 4-y = 23% | 12-15 Gy (n = 8); 18-20 Gy (n = 49); 24 Gy (n = 21) | — | — | − | 93 |
| CCG 192P (1982-84) | 27 | 4-y = 36% | 18 Gy after 1 y old | — | — | − | 138 |
| CCG 107 (1984-1987) | 99 | 4-y = 33% ± 5% SE | — | 7.2 g/m2 × 3 doses | — | + | 103 |
| CCG 1883 (1987-1993) | 135 | 4-y = 39% ± 4% SE | — | 7.2 g/m2 × 4 doses | 1.5 to 3 g/m2 q 12 h × 4 doses × 2 courses | + | 103 |
| DFCI 73-01, 77-01 81-01 (1973-1985) | 11 | 4-y = 9% ± 9% SE | 22 Gy after 1 y of age | — | — | − | 124 |
| DFCI 85-01, 87-01 91-01 (1985-1995) | 23 | 4-y = 54% ± 11% SE | 18-22 Gy | 130 mg/kg × 2-3 doses | 100 mg/kg q 12 h × 6 doses × 1 course | − | 124 |
| EORTC 58831, 58832 (1982-1989) | 28 | 4-y = 43% | 12-20 Gy at the end of therapy (first 9 points) | 2.5 g/m2 × 4 doses | — | + | 97 |
| MRC UKALL VIII, X (1980-1987) | 48 | 4-y = 30% | 18 Gy after 2 y of age | — | — | − | 94 |
| MRC UK Pilot (1987-90) | 40 | 4-y = 20% | — | 8 g/m2 × 3 doses | 0.5 g/m2 q 12 h × 10 doses 1 g/m2 q 12 h × 6 doses | + | 94 |
| POG 8398 (1984-1990) | 37 | 5-y = 17% ± 7.7% SE | — | — | — | − | 140 |
| POG 8493 (1984-1990) | 82 | 4-y = 28% ± 5% SE | — | — | — | − | 141 |
| POG 9407 Pilot (1994-1998) | 21 | 2-y = 50% | — | 4 g/m2 × 4 doses | 3 g/m2 q 12 h × 4 doses | + | 142 |
| SJCRH Study XI (1984-1988) | 11 | 5-y = 36% ± 1% SE | 18 Gy after 1 y of age | 1 g/m2 × 2 doses | — | − | 143 |
| Study (year) . | No. of patients . | Event-free survival . | Treatment . | ||||
|---|---|---|---|---|---|---|---|
| Cranial irradiation . | High-dose methotrexate . | High-dose cytarabine . | Consolidation/ reinduction therapy . | Reference . | |||
| AIEOP 88-91 (1988-1995) | 61 | 5-y = 40% | 12-18 Gy if >1 y (6 mo from diagnosis) | 5 g/m2 × 4 doses | — | + | * |
| ATRG (1984-1988) | 24 | 2-y DFS = 20% | all patients | — | — | − | 137 |
| BFM 83 (1983-1086) | 13 | 6-y = 23% ± 12% SE | ±† | — | — | − | 113 |
| BFM 86 (1986-1990) | 34 | 6-y = 37% ± 8% SE | ±† | 5 g/m2 × 4 doses | — | + | 113 |
| BFM 90 (1990-1995) | 59 | 6-y = 51% ± 7% SE | ±† | 5 g/m2 × 4 doses | — | + | 113 |
| CCG 101, 143, 141, 141 A, 162, 163 (1972-1982) | 115 | 4-y = 23% | 12-15 Gy (n = 8); 18-20 Gy (n = 49); 24 Gy (n = 21) | — | — | − | 93 |
| CCG 192P (1982-84) | 27 | 4-y = 36% | 18 Gy after 1 y old | — | — | − | 138 |
| CCG 107 (1984-1987) | 99 | 4-y = 33% ± 5% SE | — | 7.2 g/m2 × 3 doses | — | + | 103 |
| CCG 1883 (1987-1993) | 135 | 4-y = 39% ± 4% SE | — | 7.2 g/m2 × 4 doses | 1.5 to 3 g/m2 q 12 h × 4 doses × 2 courses | + | 103 |
| DFCI 73-01, 77-01 81-01 (1973-1985) | 11 | 4-y = 9% ± 9% SE | 22 Gy after 1 y of age | — | — | − | 124 |
| DFCI 85-01, 87-01 91-01 (1985-1995) | 23 | 4-y = 54% ± 11% SE | 18-22 Gy | 130 mg/kg × 2-3 doses | 100 mg/kg q 12 h × 6 doses × 1 course | − | 124 |
| EORTC 58831, 58832 (1982-1989) | 28 | 4-y = 43% | 12-20 Gy at the end of therapy (first 9 points) | 2.5 g/m2 × 4 doses | — | + | 97 |
| MRC UKALL VIII, X (1980-1987) | 48 | 4-y = 30% | 18 Gy after 2 y of age | — | — | − | 94 |
| MRC UK Pilot (1987-90) | 40 | 4-y = 20% | — | 8 g/m2 × 3 doses | 0.5 g/m2 q 12 h × 10 doses 1 g/m2 q 12 h × 6 doses | + | 94 |
| POG 8398 (1984-1990) | 37 | 5-y = 17% ± 7.7% SE | — | — | — | − | 140 |
| POG 8493 (1984-1990) | 82 | 4-y = 28% ± 5% SE | — | — | — | − | 141 |
| POG 9407 Pilot (1994-1998) | 21 | 2-y = 50% | — | 4 g/m2 × 4 doses | 3 g/m2 q 12 h × 4 doses | + | 142 |
| SJCRH Study XI (1984-1988) | 11 | 5-y = 36% ± 1% SE | 18 Gy after 1 y of age | 1 g/m2 × 2 doses | — | − | 143 |
AIEOP indicates Associazione Italiana Ematologia Oncologia Pediatrica; ATRG, Aggressive Treatment Research Group; BFM (Berlin-Frankfurt-Münster group); CCG, Children's Cancer Group; DFCI, Dana-Farber Cancer Institute/Children's Hospital ALL Consortium; EORTC, European Organization for Research and Treatment of Cancer; MRC UK, Medical Research Council, United Kingdom; POG, Pediatric Oncology Group; SJCRH, St. Jude Children's Research Hospital; DFS, disease-free survival; EFS, event-free survival.
Biondi A, unpublished, 1999.
Infants <12 months of age at the intended time of cranial irradiation (24 to 26 weeks from diagnosis) were not given preventive (12 Gy) or therapeutic (20/18 Gy) irradiation.