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Article: Improved outcome of acute lymphoblastic leukaemia treated by delayed intensification in Hong Kong children: HKALL 97 study

TitleImproved outcome of acute lymphoblastic leukaemia treated by delayed intensification in Hong Kong children: HKALL 97 study
Authors
KeywordsImmunophenotyping
Leukemia, lymphocytic, acute
Methotrexate
Prognosis
Treatment outcome
Issue Date2006
PublisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org/resources/supp.html
Citation
Hong Kong Medical Journal, 2006, v. 12 n. 1, p. 33-39 How to Cite?
AbstractObjective. To study the outcome of children with acute lymphoblastic leukaemia who were treated using a protocol including one or two delayed intensifications. Design. Prospective single-arm multicentre study. Setting. Five designated children cancer units of the Hospital Authority of Hong Kong. Patients. Children aged between 1 and 17.9 years with newly diagnosed acute lymphoblastic leukaemia seen from November 1997 to December 2002. Intervention. Chemotherapy was modified from a German Berlin-Frankfurt-Muenster 95 (BFM95) protocol that included a delayed intensification similar to the induction phase repeated 5 months after diagnosis. High-risk patients were given double delayed intensification. Main outcome measures. Overall survival and event-free survival of the whole group and the three risk groups (standard-, intermediate-, and high-risk groups), and comparison with historical controls. Results. A total of 171 patients were recruited with a median age at diagnosis of 5.57 years (range, 1.15-17.85 years). The induction remission rate was 95.3% and non-leukaemia mortality during remission was 2.3%. At 4 years, the relapse rate of this (HKALL97) study was significantly lower than that of the HKALL93 study (15.7 vs 37.3%; P<0.001). The 4-year overall survival of HKALL97 and HKALL93 studies were 86.5% and 81.8%, respectively (P=0.51). The 4-year event-free survival for HKALL 97 and HKALL93 studies were 79% and 65%, respectively (P=0.007). Nonetheless the difference of event-free survival was most remarkable in the intermediate-risk group: 75.6% and 53.1% for HKALL97 and HKALL93 studies, respectively (P=0.06). Conclusion. A more intensive delayed consolidation phase improved the outcome for children with acute lymphoblastic leukaemia by reducing relapses at 4 years. The early treatment complications were manageable and non-leukaemia mortality during remission remained low.
Persistent Identifierhttp://hdl.handle.net/10722/45218
ISSN
2015 Impact Factor: 0.887
2015 SCImago Journal Rankings: 0.279
References

 

DC FieldValueLanguage
dc.contributor.authorLi, CKen_HK
dc.contributor.authorChik, KWen_HK
dc.contributor.authorHa, SYen_HK
dc.contributor.authorLee, ACWen_HK
dc.contributor.authorYuen, HLen_HK
dc.contributor.authorLing, SCen_HK
dc.contributor.authorLee, Ven_HK
dc.contributor.authorChan, GCFen_HK
dc.contributor.authorShing, MMKen_HK
dc.contributor.authorChan, LCen_HK
dc.contributor.authorNg, MHLen_HK
dc.date.accessioned2007-10-30T06:20:08Z-
dc.date.available2007-10-30T06:20:08Z-
dc.date.issued2006en_HK
dc.identifier.citationHong Kong Medical Journal, 2006, v. 12 n. 1, p. 33-39en_HK
dc.identifier.issn1024-2708en_HK
dc.identifier.urihttp://hdl.handle.net/10722/45218-
dc.description.abstractObjective. To study the outcome of children with acute lymphoblastic leukaemia who were treated using a protocol including one or two delayed intensifications. Design. Prospective single-arm multicentre study. Setting. Five designated children cancer units of the Hospital Authority of Hong Kong. Patients. Children aged between 1 and 17.9 years with newly diagnosed acute lymphoblastic leukaemia seen from November 1997 to December 2002. Intervention. Chemotherapy was modified from a German Berlin-Frankfurt-Muenster 95 (BFM95) protocol that included a delayed intensification similar to the induction phase repeated 5 months after diagnosis. High-risk patients were given double delayed intensification. Main outcome measures. Overall survival and event-free survival of the whole group and the three risk groups (standard-, intermediate-, and high-risk groups), and comparison with historical controls. Results. A total of 171 patients were recruited with a median age at diagnosis of 5.57 years (range, 1.15-17.85 years). The induction remission rate was 95.3% and non-leukaemia mortality during remission was 2.3%. At 4 years, the relapse rate of this (HKALL97) study was significantly lower than that of the HKALL93 study (15.7 vs 37.3%; P<0.001). The 4-year overall survival of HKALL97 and HKALL93 studies were 86.5% and 81.8%, respectively (P=0.51). The 4-year event-free survival for HKALL 97 and HKALL93 studies were 79% and 65%, respectively (P=0.007). Nonetheless the difference of event-free survival was most remarkable in the intermediate-risk group: 75.6% and 53.1% for HKALL97 and HKALL93 studies, respectively (P=0.06). Conclusion. A more intensive delayed consolidation phase improved the outcome for children with acute lymphoblastic leukaemia by reducing relapses at 4 years. The early treatment complications were manageable and non-leukaemia mortality during remission remained low.en_HK
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dc.format.extent2539 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypetext/plain-
dc.format.mimetypetext/plain-
dc.languageengen_HK
dc.publisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org/resources/supp.htmlen_HK
dc.relation.ispartofHong Kong Medical Journalen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Medical Association.-
dc.subjectImmunophenotypingen_HK
dc.subjectLeukemia, lymphocytic, acuteen_HK
dc.subjectMethotrexateen_HK
dc.subjectPrognosisen_HK
dc.subjectTreatment outcomeen_HK
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols - therapeutic useen_HK
dc.subject.meshLeukemia, Lymphocytic, Acute - drug therapy - mortalityen_HK
dc.subject.meshNeoplasm Recurrence, Local - epidemiologyen_HK
dc.subject.meshDisease-Free Survivalen_HK
dc.subject.meshRemission Inductionen_HK
dc.titleImproved outcome of acute lymphoblastic leukaemia treated by delayed intensification in Hong Kong children: HKALL 97 studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1024-2708&volume=12&issue=1&spage=33&epage=39&date=2006&atitle=Improved+outcome+of+acute+lymphoblastic+leukaemia+treated+by+delayed+intensification+in+Hong+Kong+children:+HKALL+97+studyen_HK
dc.identifier.emailChan, GCF:gcfchan@hkucc.hku.hken_HK
dc.identifier.emailChan, LC:chanlc@hkucc.hku.hken_HK
dc.identifier.authorityChan, GCF=rp00431en_HK
dc.identifier.authorityChan, LC=rp00373en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid16495587en_HK
dc.identifier.scopuseid_2-s2.0-33344464932en_HK
dc.identifier.hkuros114953-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33344464932&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume12en_HK
dc.identifier.issue1en_HK
dc.identifier.spage33en_HK
dc.identifier.epage39en_HK
dc.publisher.placeHong Kongen_HK
dc.identifier.scopusauthoridLi, CK=15122650100en_HK
dc.identifier.scopusauthoridChik, KW=35580472400en_HK
dc.identifier.scopusauthoridHa, SY=7202501115en_HK
dc.identifier.scopusauthoridLee, ACW=7405631431en_HK
dc.identifier.scopusauthoridYuen, HL=7103253677en_HK
dc.identifier.scopusauthoridLing, SC=7102701299en_HK
dc.identifier.scopusauthoridLee, V=35113525600en_HK
dc.identifier.scopusauthoridChan, GCF=16160154400en_HK
dc.identifier.scopusauthoridShing, MMK=7006423846en_HK
dc.identifier.scopusauthoridChan, LC=7403540707en_HK
dc.identifier.scopusauthoridNg, MHL=35292609300en_HK

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