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Blood, 15 August 2007, Vol. 110, No. 4, pp. 1105-1111. Prepublished online as a Blood First Edition Paper on April 18, 2007; DOI 10.1182/blood-2006-12-061689. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2006-12-061689v1 110/4/1105    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Chauvenet, A. R. Articles by Camitta, B. Search for Related Content PubMed PubMed Citation Articles by Chauvenet, A. R. Articles by Camitta, B. Related Collections Free Research Articles Plenary Papers Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Antimetabolite therapy for lesser-risk B-lineage acute lymphoblastic leukemia of childhood: a report from Children's Oncology Group Study P9201 Allen R. Chauvenet1,2, Paul L. Martin3, Meenakshi Devidas2,4, Stephen B. Linda2,4, Beverly A. Bell5, Joanne Kurtzberg3, Jeanette Pullen6, Mark J. Pettenati7, Andrew J. Carroll8, Jonathan J. Shuster4, and Bruce Camitta9 1 Department of Pediatrics, Wake Forest University Medical Center, Winston-Salem, NC; 2 Children's Oncology Group, Arcadia, CA; 3 Pediatric Blood and Marrow Transplant Division, Duke University Medical Center, Durham, NC; 4 Department of Epidemiology and Health Policy Research, University of Florida, Gainesville; 5 Pediatric Hematology/Oncology, Medical College of Georgia, Augusta; 6 University of Mississippi Medical Center Children's Hospital, Jackson; 7 Pediatrics/Medical Genetics, Wake Forest University Medical Center, Winston-Salem, NC; 8 Department of Genetics, University of Alabama at Birmingham; and 9 Pediatric Hematology/Oncology, Medical College of Wisconsin, Milwaukee Pediatric Oncology Group (POG) protocol 9201 enrolled children with lesser-risk B-lineage acute lymphoblastic leukemia (ALL) defined by age (1-9), white blood cell count (WBC) less than 50 x 109/L (50 000/µL), DNA findings of trisomies 4 and 10 (or DNA index > 1.16), and lack of overt central nervous system (CNS) leukemia. After vincristine, prednisone, and asparaginase induction, 650 of 653 eligible patients attained remission (3 induction deaths) and received 6 courses of intravenous methotrexate (1 g/m2) with daily mercaptopurine. Weekly intramuscular methotrexate was added during maintenance; pulses of vincristine and prednisone were administered with periodic intrathecal chemotherapy. Treatment duration was 2.5 years. No alkylators, epipodophylotoxins, anthracyclines, or radiation were given. The 6-year event-free survival (EFS) was 86.6% with overall survival (OS) of 97.2%. Patients with less than 5% marrow blasts on induction day 15 had superior EFS. A difference not reaching conventional statistical significance (P = .068) was noted for superior outcomes in patients with trisomies of chromosomes 4 and 10 versus those lacking double trisomies. Sex, ethnicity, CNS status, and WBC were not predictive. This indicates the great majority of children with lesser-risk B-lineage ALL are curable without agents with substantial late effects. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: "Lesser" ALL: treat less or study less? James Feusner Blood 2007 110: 1086. [Full Text] [PDF] This article has been cited by other articles: J. E. Rubnitz, D. Wichlan, M. Devidas, J. Shuster, S. B. Linda, J. Kurtzberg, B. Bell, S. P. Hunger, A. Chauvenet, C.-H. Pui, et al. Prospective Analysis of TEL Gene Rearrangements in Childhood Acute Lymphoblastic Leukemia: A Children's Oncology Group Study J. Clin. Oncol., May 1, 2008; 26(13): 2186 - 2191. [Abstract] [Full Text] [PDF] S. B. Murphy Tailoring Treatment to Prognosis for Childhood Localized Non-Hodgkin's Lymphoma J. Clin. Oncol., March 1, 2008; 26(7): 1020 - 1021. [Full Text] [PDF] M. V. Relling, W. E. Evans, and C.-H. Pui Continue to study childhood ALL Blood, January 1, 2008; 111(1): 468 - 469. [Full Text] [PDF]

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