Comparison of treatment results in children with non-high risk acute lymphoblastic leukaemia treated according to ALL-BFM 90 and ALL-IC BFM 2002 regimens – single centre preliminary experience

Abstract

Background

Acute lymphoblastic leukaemia (ALL) represents about 30% of cancer in children and thus is the most common childhood malignancy. Despite the great progress, further improvement of treatment results remains an important problem.

Aim

A comparison of the results of standard risk and intermediate risk group regimens ALL-BFM 90 and ALL IC-BFM 2002 was the subject of our study.

Materials/Methods

A retrospective analysis of 41 (18 males and 23 females) children aged 2–15 years (median: 6 years) diagnosed from 25.01.1994 to 9.04.1997 and treated according to ALL-BFM 90 (group A), and 44 (22 males and 22 females) children aged 0-18 years (median: 7 years) diagnosed from 12.10.2002 to 31.12.2005 and treated according to ALL IC BFM-2002 regimen (group B) was performed. For statistical evaluation Kaplan–Meier methods and the log-rank test were used.

Results

Remission on time (day +33) was achieved in 39/41 (94%) children from group A and in 43/44 (98%) children from group B (p=0.07). The average day of achieving remission was 49 (range: 28–109; median: 46) in group A and 39 (range: 31–71; median: 35) in group B (p<0.001). Treatment failures observed in both groups were as follows:

• •

  death during induction therapy: 0/41 (0%) – group A, 1/44 (2%) – group B; p=0.954;

• •

  relapse: 2/41 (5%) – group A, 3/43 (7%) – group B; p=1.000

• •

  death after relapse: 2/2 (100%) – group A, 0/3 (0%) – group B; p=0.100.

Probability of 43 months event-free survival (pEFS) was 95.2% in ALL-BFM 90 and 92.7% in ALL IC-BFM 2002 (p=0.452).

Conclusions

• 1.

  The average day of achieving remission was significantly shorter in children treated according to ALL IC–BFM 2002.

• 2.

  Although the number of relapses increased, there were no cases of death in relapsed patients observed in the ALL IC–BFM 2002 group.

• 3.

  The follow-up was too short to evaluate the long-term effects of ALL treatment. Further observation of investigated groups of patients is necessary.