Intensified chemotherapy without SCT in infant ALL: Results from COG P9407 (Cohort 3)

Zoann E. Dreyer; Joanne M. Hilden; Tamekia L. Jones; Meenakshi Devidas; Naomi J. Winick; Cheryl L. Willman; Richard C. Harvey; I. Ming Chen; Fred G. Behm; Jeanette Pullen; Brent L. Wood; Andrew J. Carroll; Nyla A. Heerema; Carolyn A. Felix; Blaine Robinson; Gregory H. Reaman; Wanda L. Salzer; Stephen P. Hunger; William L. Carroll; Bruce M. Camitta

doi:10.1002/pbc.25322

Intensified chemotherapy without SCT in infant ALL: Results from COG P9407 (Cohort 3)

Zoann E. Dreyer, Joanne M. Hilden, Tamekia L. Jones, Meenakshi Devidas, Naomi J. Winick, Cheryl L. Willman, Richard C. Harvey, I. Ming Chen, Fred G. Behm, Jeanette Pullen, Brent L. Wood, Andrew J. Carroll, Nyla A. Heerema, Carolyn A. Felix, Blaine Robinson, Gregory H. Reaman, Wanda L. Salzer, Stephen P. Hunger, William L. Carroll, Bruce M. Camitta

Laboratory Medicine and Pathology

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Infants with acute lymphoblastic leukemia (ALL) present with aggressive disease and a poor prognosis. Early relapse within 6-9 months of diagnosis is common. Approximately 75% of infants have MLL-rearranged (MLL-R) ALL with event free survival (EFS) ranging from 20% to 30%. Children's Oncology Group (COG) P9407 used shortened (46 weeks), intensified therapy to address early relapse and poor EFS. Procedure: P9407 therapy was modified three times for induction toxicity resulting in three cohorts of therapy. One hundred forty-seven infants were enrolled in the third cohort. Results: We report an overall 5-year EFS and OS of 42.3±6% and 52.9±6.5% respectively. Poor prognostic factors included age ≤90 days at diagnosis, MLL-R ALL and white cell count ≥50,000/μl. For infants ≤90 days of age, the 5-year EFS was 15.5±10.1% and 48.5±6.7% for those >90 days (P<0.0001). Among infants >90 days of age, 5-year EFS rates were 43.8±8% for MLL-R versus 69.1±13.6% for MLL-germline ALL (P<0.0001). Conclusions: Age ≤90 days at diagnosis was the most important prognostic factor. Despite shortened therapy with early intensification, EFS remained less than 50% overall in MLL-R ALL.

Original language	English (US)
Pages (from-to)	419-426
Number of pages	8
Journal	Pediatric Blood and Cancer
Volume	62
Issue number	3
DOIs	https://doi.org/10.1002/pbc.25322
State	Published - Mar 1 2015

Keywords

COG P9407
Infant ALL
Intensified therapy without SCT

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Hematology
Oncology

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10.1002/pbc.25322

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Dreyer, Z. E., Hilden, J. M., Jones, T. L., Devidas, M., Winick, N. J., Willman, C. L., Harvey, R. C., Chen, I. M., Behm, F. G., Pullen, J., Wood, B. L., Carroll, A. J., Heerema, N. A., Felix, C. A., Robinson, B., Reaman, G. H., Salzer, W. L., Hunger, S. P., Carroll, W. L., & Camitta, B. M. (2015). Intensified chemotherapy without SCT in infant ALL: Results from COG P9407 (Cohort 3). Pediatric Blood and Cancer, 62(3), 419-426. https://doi.org/10.1002/pbc.25322

Dreyer, ZE, Hilden, JM, Jones, TL, Devidas, M, Winick, NJ, Willman, CL, Harvey, RC, Chen, IM, Behm, FG, Pullen, J, Wood, BL, Carroll, AJ, Heerema, NA, Felix, CA, Robinson, B, Reaman, GH, Salzer, WL, Hunger, SP, Carroll, WL & Camitta, BM 2015, 'Intensified chemotherapy without SCT in infant ALL: Results from COG P9407 (Cohort 3)', Pediatric Blood and Cancer, vol. 62, no. 3, pp. 419-426. https://doi.org/10.1002/pbc.25322

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title = "Intensified chemotherapy without SCT in infant ALL: Results from COG P9407 (Cohort 3)",

abstract = "Background: Infants with acute lymphoblastic leukemia (ALL) present with aggressive disease and a poor prognosis. Early relapse within 6-9 months of diagnosis is common. Approximately 75% of infants have MLL-rearranged (MLL-R) ALL with event free survival (EFS) ranging from 20% to 30%. Children's Oncology Group (COG) P9407 used shortened (46 weeks), intensified therapy to address early relapse and poor EFS. Procedure: P9407 therapy was modified three times for induction toxicity resulting in three cohorts of therapy. One hundred forty-seven infants were enrolled in the third cohort. Results: We report an overall 5-year EFS and OS of 42.3±6% and 52.9±6.5% respectively. Poor prognostic factors included age ≤90 days at diagnosis, MLL-R ALL and white cell count ≥50,000/μl. For infants ≤90 days of age, the 5-year EFS was 15.5±10.1% and 48.5±6.7% for those >90 days (P<0.0001). Among infants >90 days of age, 5-year EFS rates were 43.8±8% for MLL-R versus 69.1±13.6% for MLL-germline ALL (P<0.0001). Conclusions: Age ≤90 days at diagnosis was the most important prognostic factor. Despite shortened therapy with early intensification, EFS remained less than 50% overall in MLL-R ALL.",

keywords = "COG P9407, Infant ALL, Intensified therapy without SCT",

author = "Dreyer, {Zoann E.} and Hilden, {Joanne M.} and Jones, {Tamekia L.} and Meenakshi Devidas and Winick, {Naomi J.} and Willman, {Cheryl L.} and Harvey, {Richard C.} and Chen, {I. Ming} and Behm, {Fred G.} and Jeanette Pullen and Wood, {Brent L.} and Carroll, {Andrew J.} and Heerema, {Nyla A.} and Felix, {Carolyn A.} and Blaine Robinson and Reaman, {Gregory H.} and Salzer, {Wanda L.} and Hunger, {Stephen P.} and Carroll, {William L.} and Camitta, {Bruce M.}",

note = "Publisher Copyright: {\textcopyright} 2014 Wiley Periodicals, Inc.",

year = "2015",

month = mar,

day = "1",

doi = "10.1002/pbc.25322",

language = "English (US)",

volume = "62",

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TY - JOUR

T1 - Intensified chemotherapy without SCT in infant ALL

T2 - Results from COG P9407 (Cohort 3)

AU - Dreyer, Zoann E.

AU - Hilden, Joanne M.

AU - Jones, Tamekia L.

AU - Devidas, Meenakshi

AU - Winick, Naomi J.

AU - Willman, Cheryl L.

AU - Harvey, Richard C.

AU - Chen, I. Ming

AU - Behm, Fred G.

AU - Pullen, Jeanette

AU - Wood, Brent L.

AU - Carroll, Andrew J.

AU - Heerema, Nyla A.

AU - Felix, Carolyn A.

AU - Robinson, Blaine

AU - Reaman, Gregory H.

AU - Salzer, Wanda L.

AU - Hunger, Stephen P.

AU - Carroll, William L.

AU - Camitta, Bruce M.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Background: Infants with acute lymphoblastic leukemia (ALL) present with aggressive disease and a poor prognosis. Early relapse within 6-9 months of diagnosis is common. Approximately 75% of infants have MLL-rearranged (MLL-R) ALL with event free survival (EFS) ranging from 20% to 30%. Children's Oncology Group (COG) P9407 used shortened (46 weeks), intensified therapy to address early relapse and poor EFS. Procedure: P9407 therapy was modified three times for induction toxicity resulting in three cohorts of therapy. One hundred forty-seven infants were enrolled in the third cohort. Results: We report an overall 5-year EFS and OS of 42.3±6% and 52.9±6.5% respectively. Poor prognostic factors included age ≤90 days at diagnosis, MLL-R ALL and white cell count ≥50,000/μl. For infants ≤90 days of age, the 5-year EFS was 15.5±10.1% and 48.5±6.7% for those >90 days (P<0.0001). Among infants >90 days of age, 5-year EFS rates were 43.8±8% for MLL-R versus 69.1±13.6% for MLL-germline ALL (P<0.0001). Conclusions: Age ≤90 days at diagnosis was the most important prognostic factor. Despite shortened therapy with early intensification, EFS remained less than 50% overall in MLL-R ALL.

AB - Background: Infants with acute lymphoblastic leukemia (ALL) present with aggressive disease and a poor prognosis. Early relapse within 6-9 months of diagnosis is common. Approximately 75% of infants have MLL-rearranged (MLL-R) ALL with event free survival (EFS) ranging from 20% to 30%. Children's Oncology Group (COG) P9407 used shortened (46 weeks), intensified therapy to address early relapse and poor EFS. Procedure: P9407 therapy was modified three times for induction toxicity resulting in three cohorts of therapy. One hundred forty-seven infants were enrolled in the third cohort. Results: We report an overall 5-year EFS and OS of 42.3±6% and 52.9±6.5% respectively. Poor prognostic factors included age ≤90 days at diagnosis, MLL-R ALL and white cell count ≥50,000/μl. For infants ≤90 days of age, the 5-year EFS was 15.5±10.1% and 48.5±6.7% for those >90 days (P<0.0001). Among infants >90 days of age, 5-year EFS rates were 43.8±8% for MLL-R versus 69.1±13.6% for MLL-germline ALL (P<0.0001). Conclusions: Age ≤90 days at diagnosis was the most important prognostic factor. Despite shortened therapy with early intensification, EFS remained less than 50% overall in MLL-R ALL.

KW - COG P9407

KW - Infant ALL

KW - Intensified therapy without SCT

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DO - 10.1002/pbc.25322

M3 - Article

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AN - SCOPUS:84921437872

SN - 1545-5009

VL - 62

SP - 419

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JO - Pediatric Blood and Cancer

JF - Pediatric Blood and Cancer

IS - 3

ER -

Intensified chemotherapy without SCT in infant ALL: Results from COG P9407 (Cohort 3)

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Keywords

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