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Blood, Vol. 94 No. 4 (August 15), 1999:
pp. 1209-1217
Prednisone Response Is the Strongest Predictor of Treatment
Outcome in Infant Acute Lymphoblastic Leukemia
Michael Dördelmann,
Alfred Reiter,
Arndt Borkhardt,
Wolf-Dieter Ludwig,
Nicolai Götz,
Susanne Viehmann,
Helmut Gadner,
Hansjörg Riehm, and
Martin Schrappe for the ALL-BFM Group
From the Department of Pediatric Hematology and Oncology, Medical
School Hannover, Hannover, Germany; the Oncogenetic Laboratory,
University of Gie en, Gieen, Germany; the Department of
Hematology, Oncology and Tumor Immunology, Robert-Rössle-Clinic,
Charité, Humboldt University Berlin, Berlin, Germany; and St Anna
Kinderspital, Vienna, Austria.
To define prognostic factors in infant acute lymphoblastic leukemia
(ALL), the outcome of 106 infants (age  12 months) during 3 consecutive multicenter trials of the Berlin-Frankfurt-Münster group (ALL-BFM 83, 86, and 90) was retrospectively analyzed according to presenting features and early in vivo response to prednisone. The
prednisone response was defined as the cytoreduction (number of blood
blasts per microliter at day 8) to a 7-day prednisone prephase and 1 intrathecal dose of methotrexate on day 1. Prednisone good responder
(PGR; <1,000 blasts/µL) received conventional therapy and
prednisone poor responder (PPR;  1,000 blasts/µL) received intensified therapy. Infant ALL was characterized by a high incidence of a white blood cell count greater than 100 × 103/µL
(57%), central nervous system leukemia (24%), lack of CD10 expression
(59%), 11q23 rearrangement (49%) including the translocation t(4;11)
(29%), and a comparatively high proportion of PPR (26%), which were
all significantly associated with inferior outcome by univariate
analysis. The estimated probability for an event-free survival at 6 years (pEFS) was by far better for PGR compared with PPR, who had a
dismal prognosis despite intensified treatment (pEFS, 53% ± 6%
v 15% ± 7%, P = .0001). Infant PGR, who were less than 6 months of age (n = 40), lacked CD10 expression (n = 43), and/or had an 11q23 rearrangement (n = 17) fared
significantly better compared with corresponding PPR, as indicated by a
pEFS of 44% ± 8%, 49% ± 8%, and 41% ± 12%, respectively. In
multivariate analysis, PPR was the strongest adverse prognostic factor
(relative risk, 3.3; 95% confidence interval, 1.9 to 5.8; P < .0001). Infants with PGR, comprising a major subgroup (74%) among
infants, might successfully be treated with conventional therapy,
whereas PPR require new therapeutic strategies, including early
treatment intensification or bone marrow transplantation in first remission.
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|
|
|
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|
|
|
|
|
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|
|
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|
|
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