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Blood, 1 March 2008, Vol. 111, No. 5, pp. 2548-2555. Prepublished online as a Blood First Edition Paper on November 26, 2007; DOI 10.1182/blood-2007-02-070342. This Article Full Text Full Text (PDF) Supplemental Appendix Erratum (v111,p5262) All Versions of this Article: blood-2007-02-070342v1 111/5/2548    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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Seibel, N. L. Articles by Gaynon, P. S. Search for Related Content PubMed PubMed Citation Articles by Seibel, N. L. Articles by Gaynon, P. S. Related Collections Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Early postinduction intensification therapy improves survival for children and adolescents with high-risk acute lymphoblastic leukemia: a report from the Children's Oncology Group Nita L. Seibel1, Peter G. Steinherz2, Harland N. Sather3, James B. Nachman4, Cynthia DeLaat5, Lawrence J. Ettinger6, David R. Freyer7, Leonard A. Mattano, Jr8, Caroline A. Hastings9, Charles M. Rubin4, Kathy Bertolone10, Janet L. Franklin11, Nyla A. Heerema12, Torrey L. Mitchell13, Allan F. Pyesmany14, Mei K. La3, Cheryl Edens15, and Paul S. Gaynon11 1 Hematology/Oncology, Children's National Medical Center and George Washington University School of Medicine and Public Health, Washington, DC; 2 Memorial Sloan Kettering Cancer Center, New York, NY; 3 Group Operations Center, Children's Oncology Group, Arcadia, CA; 4 University of Chicago Comer Children's Hospital, IL; 5 Cincinnati Children's Hospital Medical Center, OH; 6 St Peter's University Hospital, New Brunswick, NJ; 7 DeVos Children's Hospital, Grand Rapids, MI; 8 Kalamazoo Center for Medical Studies, MI; 9 Children's Hospital and Research Center Oakland, CA; 10 Kosair Children's Hospital, Louisville, KY; 11 Children's Hospital of Los Angeles, CA; 12 Ohio State University College of Medicine, Columbus; 13 Raymond Blank Children's Hospital, Des Moines, IA; 14 Izaak Walton Killam (IWK) Health Center, Halifax, NS; and 15 Department of Hematology/Oncology, Vanderbilt University, Nashville, TN Longer and more intensive postinduction intensification (PII) improved the outcome of children and adolescents with "higher risk" acute lymphoblastic leukemia (ALL) and a slow marrow response to induction therapy. In the Children's Cancer Group study (CCG-1961), we tested longer versus more intensive PII, using a 2 x 2 factorial design for children with higher risk ALL and a rapid marrow response to induction therapy. Between November 1996 and May 2002, 2078 children and adolescents with newly diagnosed ALL (1 to 9 years old with white blood count 50 000/ or more, or 10 years of age or older with any white blood count) were enrolled. After induction, 1299 patients with marrow blasts less than or equal to 25% on day 7 of induction (rapid early responders) were randomized to standard or longer duration (n = 651 + 648) and standard or increased intensity (n = 649 + 650) PII. Stronger intensity PII improved event-free survival (81% vs 72%, P < .001) and survival (89% vs 83%, P = .003) at 5 years. Differences were most apparent after 2 years from diagnosis. Longer duration PII provided no benefit. Stronger intensity but not prolonged duration PII improved outcome for patients with higher-risk ALL. This study is registered at http://clinicaltrials.gov as NCT00002812 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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