Experience with BFM 1990 Protocol Treatment of Recurrent Childhood Lymphoblastic Leukemia. Report of the Polish Children’s Leukemia/Lymphoma Study Group
Between 1993 and 1996,54 children aged from 6 mths-18 years (16 girls and 38 boys) with first relapse of acute lymphoblastic leukemia were included to the study. The children were treated according to the BFM 90 relapse protocol. There were 40 cases with early (including 14 children with very early) and 14 cases with late relapse (BM-30, local-12, combined 12). The probability of EFS were calculated according to the Kaplan-Meier method.
The overall second complete remission (CR) rate in very early was 71.42%, in early relapse was 73.07% and in late relapse 78.57%. The probability of overall event-free survival (EFS) after 2 years was 39.9%. The EFS achieved in children with late relapses was four times higher when compared with early and very early relapses 73.2% vs. 59% vs.29.2% (p = 0.05).
The results obtained with BFM 90 chemotherapy in children with first late relapse are acceptable. One must conclude that for children with early relapses, other chemotherapy methods together with BMT in second remission should be applied.
KeywordsAcute Lymphoblastic Leukemia Early Relapse Late Relapse Childhood Acute Lymphoblastic Leukemia Extramedullary Relapse
Unable to display preview. Download preview PDF.
- 1.Brisco MJ, Condon J, Hughes E, Neoh SH, Sykes PJ, Seshadri R, Toogood I, Waters K, Tauro G, Ekert H, Morley AA (1994) Outcome prediction in childhood acute lymphoblastic leukaemia by molecular quantification of residual disease at the end of induction. Lancet 343: 196–199PubMedCrossRefGoogle Scholar
- 2.Falleta JM, Schuster JJ, Grist WM, Pullen J, Bortowitz MJ, Wharam M, Patterson R, Foreman E, Vietti TJ (1992). Different patterns of relapse associated with three intensive treatment regiments for pediatric E-rosette positive T-cell leukemia: a Pediatric Oncology Study Group. Leukemia 6: 541–546Google Scholar
- 7.Riviera GK, Santana V, Mahmoud H, Buchanan G, Crist WM (1989) Acute lymphoblastic leukemia of childhood: the problem of relapses. BMT 4: 80–85Google Scholar
- 9.Conter V, Arico M, Valsecchi MG et al. (1995) Extended intrathecal methotrexate mat replace cranial irradiation for prevention of CNS relapse in children with intermediate-risk acute lymphoblastic leukemia treated with BerlinMunster-based intensive chemotherapy. J Clin Oncol 13/10: (2497–2502)PubMedGoogle Scholar
- 10.Boguslawska-Jaworska J, Chybicka A, Kazanowska B, Pietras W, Armata J, Balwierz W, Bubala H, Jackowska T, Koehler T, Michalewska D, Ochocka M, Radwanska U, Rokicka-Milewska R, Rytlewska M, Skomra S, Sladkowska G, Zelenay E (1990) The results of ALL relapses treatment according to BFM protocol in experience of the Polish children’s leukemia/lymphoma study group. Prac Nauk AM: Suppl 88–95Google Scholar
- 11.Sauerbrey A, Zintl F, Malke H, Reimann M, Maaser M, Domula M, Dorffel W, Eggers G, Exadaktylos P, Kotte W (1993) Results and experiences with a modified BFM protocol for treatment of recurrence in children with acute lymphoblastic leukemia in East German areas. Klin PNdiatr 205: 281–287, Cancer 73: 219–223Google Scholar
- 12.Behrendt H, Leeuven E, Schurwirth C, Verkes R, Hermans J, Does van der Berg,Wering ER (1990) Bone marrow relapse occurring as first relapse in children with acute lymphoblastic leukemia. Med Oed Oncol 18: 190–196Google Scholar
- 20.Butturini A (1987) Which treatment for childhood acute lymphoblastic leukemia in second remission? Lancet: 429–432Google Scholar