SEARCH:   Advanced

Blood, 1 February 2008, Vol. 111, No. 3, pp. 1044-1053. Prepublished online as a Blood First Edition Paper on November 13, 2007; DOI 10.1182/blood-2007-04-084293. This Article Full Text (PDF) Supplemental Appendix and Figure All Versions of this Article: blood-2007-04-084293v1 111/3/1044    most recent Alert me when this article is cited Alert me if a correction is posted 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 Lange, B. J Articles by Alonzo, T. A Search for Related Content PubMed PubMed Citation Articles by Lange, B. J Articles by Alonzo, T. A Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted April 19, 2007 Accepted September 29, 2007 Outcomes in CCG-2961, a Children's Oncology Group phase 3 trial for untreated pediatric acute myeloid leukemia (AML): a report from the Children's Oncology Group Beverly J Lange*, Franklin O. Smith, James Feusner, Dorothy Barnard, Patricia Dinndorf, Stephen Feig, Nyla A Heerema, Carola Arndt, Robert J Arceci, Nita Seibel, Margie Weiman, Kathryn Dusenbery, Kevin Shannon, Sandra Luna-Fineman, Robert B Gerbing, and Todd A Alonzo The University of Pennsylvania School of Medicine and The Children's Hospital of Philadelphia, Philadelphia, PA, United States Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, OH, United States Children's Hospital of Oakland, Oakland, CA, United States Izaak W. Killam Hospital for Children, Nova Scotia, Canada Food and Drug Administration, Silver Spring, MD, United States University of California Los Angeles School of Medicine, Los Angeles, CA, United States Ohio State School of Medicine, Columbus, OH, United States Mayo Clinic, Rochester, MN, United States Johns Hopkins University School of Medicine, Baltimore, MD, United States Children's National Medical Center, Washington, D.C., United States University of Minnesota School of Medicine, Minneapolis, MN, United States University of California San Francisco School of Medicine, San Francisco, CA, United States California Pacific Medical Center, San Francisco, CA, United States Children's Oncology Group, Arcadia, CA, United States University of Southern California, Los Angeles, CA, United States * Corresponding author; email: lange{at}email.chop.edu. CCG-2961 incorporated three new agents, idarubicin, fludarabine and interleukin-2, into a phase 3 AML trial based on intensive-timing remission induction/consolidation and related donor marrow transplantation or high-dose cytarabine intensification. Among 901 patients age <21 years, survival was 52±5%. Five-year survival improved from 43±7% for those enrolled between 1996 and1998 to 57±6% between 2000 and 2002 (P=0.005) while treatment-related mortality declined from 19±5% to 12±3% (P=0.025). Partial replacement of standard daunomycin with idarubicin in the five-drug induction combination achieved a remission rate of 88.5%, similar to historical controls. Post-remission randomization effected 56.4% survival at five years in patients receiving five-drug reinduction and those receiving fludarabine/cytarabine/ idarubicin. For patients with or without a related donor, five-year disease-free survival was 60±8% and 50±5% (P=0.021) respectively; respective survival was 67±8% and 62±5% (P=0.425). Donor availability conferred no benefit on those with inv(16) or t(8;21) cytogenetics. After high-dose cytarabine intensification, patients randomized to interleukin-2 or none experienced similar outcomes. Five-year event-free survival was 42±3%. Factors predictive of inferior survival were age >16 years, non-Caucasian ethnicity, absence of related donor, obesity, WBC >100,000x109/L, -7/7q-, -5/5q- and/or complex karyotype. The new agents did not effect significantly better outcomes; experience may have contributed to improvement over time. This study is registered at http://clinicaltrials.gov as NCT00002798. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: B. V. Balgobind, S. C. Raimondi, J. Harbott, M. Zimmermann, T. A. Alonzo, A. Auvrignon, H. B. Beverloo, M. Chang, U. Creutzig, M. N. Dworzak, et al. Novel prognostic subgroups in childhood 11q23/MLL-rearranged acute myeloid leukemia: results of an international retrospective study Blood, September 17, 2009; 114(12): 2489 - 2496. [Abstract] [Full Text] [PDF] P. A. Ho, T. A. Alonzo, R. B. Gerbing, J. Pollard, D. L. Stirewalt, C. Hurwitz, N. A. Heerema, B. Hirsch, S. C. Raimondi, B. Lange, et al. Prevalence and prognostic implications of CEBPA mutations in pediatric acute myeloid leukemia (AML): a report from the Children's Oncology Group Blood, June 25, 2009; 113(26): 6558 - 6566. [Abstract] [Full Text] [PDF] J. STYCZYNSKI, L. GIL, K. DERWICH, J. WACHOWIAK, W. BALWIERZ, W. BADOWSKA, M. KRAWCZUK-RYBAK, M. MATYSIAK, M. WIECZOREK, A. BALCERSKA, et al. Comparison of Clofarabine Activity in Childhood and Adult Acute Leukemia: Individual Tumor Response Study Anticancer Res, May 1, 2009; 29(5): 1643 - 1650. [Abstract] [Full Text] [PDF] C. M. Hartford, S. Duan, S. M. Delaney, S. Mi, E. O. Kistner, J. K. Lamba, R. S. Huang, and M. E. Dolan Population-specific genetic variants important in susceptibility to cytarabine arabinoside cytotoxicity Blood, March 5, 2009; 113(10): 2145 - 2153. [Abstract] [Full Text] [PDF] E. L.J.M. Smits, Z. N. Berneman, and V. F.I. Van Tendeloo Immunotherapy of Acute Myeloid Leukemia: Current Approaches Oncologist, March 1, 2009; 14(3): 240 - 252. [Abstract] [Full Text] [PDF] U. Creutzig, M. Zimmermann, G. Kaspers, and D. Reinhardt Postremission Management of Acute Myelogenous Leukemia in Children and Adolescents with and without Hematopoietic Stem Cell Transplantation in European and U.S. Study Groups ASCO Educational Book, January 1, 2009; 2009(1): 609 - 615. [Abstract] [Full Text] [PDF] J. T. Horan, T. A. Alonzo, G. H. Lyman, R. B. Gerbing, B. J. Lange, Y. Ravindranath, D. Becton, F. O. Smith, and W. G. Woods Impact of Disease Risk on Efficacy of Matched Related Bone Marrow Transplantation for Pediatric Acute Myeloid Leukemia: The Children's Oncology Group J. Clin. Oncol., December 10, 2008; 26(35): 5797 - 5801. [Abstract] [Full Text] [PDF] M. R. Baer, S. L. George, M. A. Caligiuri, B. L. Sanford, S. M. Bothun, K. Mrozek, J. E. Kolitz, B. L. Powell, J. O. Moore, R. M. Stone, et al. Low-Dose Interleukin-2 Immunotherapy Does Not Improve Outcome of Patients Age 60 Years and Older With Acute Myeloid Leukemia in First Complete Remission: Cancer and Leukemia Group B Study 9720 J. Clin. Oncol., October 20, 2008; 26(30): 4934 - 4939. [Abstract] [Full Text] [PDF]

	Copyright © 2007 by American Society of Hematology         Online ISSN: 1528-0020