ISSN (print) 1997-6933     ISSN (online) 2500-2139
Vol. 15 No. 2 (2022), LYMPHOID TUMORS
Vol. 15 No. 2 (2022)
LYMPHOID TUMORS

Protocol ALL-IC BFM 2002: Outcomes of Pediatric Acute Lymphoblastic Leukemia Treatment under Multi-Center Clinical Trial

Published 01.04.2022
Timur Teimurazovich Valiev
Research Institute of Pediatric Oncology and Hematology, NN Blokhin National Medical Cancer Research Center, 23 Kashirskoye sh., Moscow, Russian Federation, 115478
M.A. Shervashidze
Research Institute of Pediatric Oncology and Hematology, NN Blokhin National Medical Cancer Research Center, 23 Kashirskoye sh., Moscow, Russian Federation, 115478
I.V. Osipova
Pediatric Republican Clinical Hospital of Tatarstan, 140 Orenburgskii trakt, Kazan, Russian Federation, 420138
T.I. Burlutskaya
Pediatric Regional Clinical Hospital, 44 Gubkina ul., Belgorod, Russian Federation, 308036
N.A. Popova
Volgograd Regional Clinical Oncology Dispensary, 78 Zemlyachki ul., Volgograd, Russian Federation, 400138
N.S. Osmulskaya
Regional Pediatric Clinical Hospital, 77 Kuibysheva ul., Omsk, Russian Federation, 644001
G.A. Aleskerova
Azerbaijan National Center for Oncology, 79b G. Zardabi ul., Baku, Azerbaijan, AZ1011
S.L. Sabantsev
LI Sokolova Ioshkar-Ola Pediatric Municipal Hospital, 104 Volkova ul., Ioshkar-Ola, Russian Federation, 424004
Z.S. Gordeeva
LI Sokolova Ioshkar-Ola Pediatric Municipal Hospital, 104 Volkova ul., Ioshkar-Ola, Russian Federation, 424004
V.Yu. Smirnov
Kaluga Regional Clinical Pediatric Hospital, 1 Vishnevskogo ul., Kaluga, Russian Federation, 248007
O.A. Poberezhnaya
Kaluga Regional Clinical Pediatric Hospital, 1 Vishnevskogo ul., Kaluga, Russian Federation, 248007
S.N. Yuldasheva
VK Gusak Institute of Emergency and Reconstructive surgery, 47 Leninskii pr-t, Donetsk, Donetsk People’s Republic, 83003
I.A. Babich
Regional Pediatric Hospital, 311 Lenina ul., Yuzhno-Sakhalinsk, Russian Federation, 693006
N.A. Batmanova
Research Institute of Pediatric Oncology and Hematology, NN Blokhin National Medical Cancer Research Center, 23 Kashirskoye sh., Moscow, Russian Federation, 115478
S.R. Varfolomeeva
Research Institute of Pediatric Oncology and Hematology, NN Blokhin National Medical Cancer Research Center, 23 Kashirskoye sh., Moscow, Russian Federation, 115478
PDF_2022-15-2-119-129 (Russian)

Keywords

acute lymphoblastic leukemia
treatment
ALL-IC BFM 2002
children

How to Cite

Valiev T.T., Shervashidze M.A., Osipova I.V., Burlutskaya T.I., Popova N.A., Osmulskaya N.S., Aleskerova G.A., Sabantsev S.L., Gordeeva Z.S., Smirnov V.Y., Poberezhnaya O.A., Yuldasheva S.N., Babich I.A., Batmanova N.A., Varfolomeeva S.R. Protocol ALL-IC BFM 2002: Outcomes of Pediatric Acute Lymphoblastic Leukemia Treatment under Multi-Center Clinical Trial. Clinical Oncohematology. 2022;(2):119–129. doi:10.21320/2500-2139-2022-15-2-119-129.
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver AMA ГОСТ

Download Citation

Endnote/Zotero/Mendeley (RIS) BibTeX

Statistics

Annotation views: 3
PDF_2022-15-2-119-129 (Russian) downloads: 1

Keywords

Abstract

Background. Programs of pediatric acute lymphoblastic leukemia (ALL) treatment, developed by the BFM (Berlin-Frankfurt-Munster) Group in 2002, remain one the most effective in the world. Long-term (10–15 years) overall survival in ALL children is above 90 %. Great progress in ALL treatment provided ground for including the ALL-IC BFM 2002 protocol into the Clinical Guidelines in 2020 (ID: 529).

Aim. To present the outcomes of ALL treatment in children according to ALL-IC BFM 2002 under the multi-center clinical trial.

Materials & Methods. From 01.11.2003 to 12.10.2021 the multi-center retrospective-prospective trial included 433 patients with newly diagnosed ALL, aged between 3 months and 21 years. The patients were aged from 0 to 12 (n = 344), from 12 to 18 (n = 70), and older than 12 years (n = 19). All of them were treated with ALL-IC BFM 2002. Overall (OS), disease-free (DFS), and event-free (EFS) survivals were estimated as of 01.12.2021.

Results. In the vast majority of patients (97.9 %, n = 424) complete clinical hematological remission was reached by Day 33 of the ALL-IC BFM 2002 treatment. The 10-year OS was 91.8 ± 1.5 %, DFS was 87.4 ± 1.8 %, and EFS was 84.1 ± 1.9 %. The 10-year OS in the groups of standard- and intermediate-risk patients was 92.8 ± 1.7 % and 94.6 ± 2.6 %, respectively, whereas in high-risk ALL relapse patients it was 71.1 ± 11.1 %.

Conclusion. The ALL-IC BFM 2002 protocol for treating pediatric ALL is reproducible in federal and regional clinics. The outcomes of the ALL-IC BFM 2002 treatment appeared to be impressive. They are comparable to those achieved in leading European and American clinics. To improve survival of high-risk patients, additional stratifying criteria are required, one of which should be the assessment of minimal residual disease (MRD). MRD detection became a basis for prognostic risk stratification under ALL-IC BFM 2009, the results of which will be presented in 2022–2023.

PDF_2022-15-2-119-129 (Russian)

References

  1. Румянцев А.Г. Эволюция лечения острого лимфобластного лейкоза у детей: эмпирические, биологические и организационные аспекты. Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2015;14(1):5–15.
  2. [Rumyantsev AG. Evolution of treatment of acute lymphoblastic leukemia in children: empirical, biological and organizational aspects. Voprosy gematologii/onkologii i immunopatologii v pediatrii. 2015;14(1):5–15. (In Russ)]
  3. Pinkel D. History and development of total therapy for acute lymphocytic leukemia. In: Murphy SB, Gilbert JR, eds. Leukemia research: advances in cell biology and treatment. New York: Elsevier Science Publ.; 1983. pp. 189–201.
  4. Riehm H, Gadner H, Henze G, et al. Acute lymphoblastic leukemia: treatment in three BFM studies (1970–1981). In: Murphy SB, Gilbert JR, eds. Leukemia research: advances in cell biology and treatment. New York: Elsevier Science Publ.; 1983. pp. 251–63.
  5. Langermann HJ, Henze G, Wulf M, Riehm H. Estimation of tumor cell mass in childhood acute lymphoblastic leukemia: prognostic significance and practical application. Klin 1982;194(4):209–13. doi: 10.1055/s-2008-1033807.
  6. Riehm H, Feickert HJ, Schrappe М, et al. Therapy results in five ALL-BFM studies since 1970: implications of risk factors for prognosis. Haematol Blood Transfus. 1987;30:139–46. doi: 10.1007/978-3-642-71213-5_21.
  7. Moricke A, Zimmermann M, Reiter A, et al. Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000. Leukemia. 2010;24(2):265–84. doi: 10.1038/leu.2009.257.
  8. Sullivan МP, Chen Т, Dyment PG, et al. Equivalence of intrathecal chemotherapy and radiotherapy as central nervous system prophylaxis in children with acute lymphatic leukemia: a Pediatric Oncology Group study. Blood. 1982;60(4):948–58.
  9. Bleyer WA, Coccia PF, Sather HN, et al. Reduction of central nervous system leukemia with a pharmacokinetically derived intrathecal methotrexate dosage regimen. J Clin Oncol. 1983;1(5):317–25. doi: 10.1200/JCO.1983.1.5.317.
  10. Sackmann-Muriel F, Felice MS, Zubizarreta PA, et al. Treatment results in childhood acute lymphoblastic leukemia with a modified ALL-BFM’90 protocol: lack of improvement in high-risk group. Leuk Res. 1999;23(4):331–40. doi: 10.1016/s0145-2126(98)00162-3.
  11. Moricke A, Reiter A, Zimmermann M, et al. Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: treatment results of 2169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95. 2008;111(9):4477–89. doi: 10.1182/blood-2007-09-112920.
  12. Stary J, Zimmermann M, Campbell M, et al. Intensive chemotherapy for childhood acute lymphoblastic leukemia: results of the randomized intercontinental trial ALL IC-BFM 2002. J Clin Oncol. 2014;32(3):174–84. doi: 10.1200/JCO.2013.48.6522.
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Copyright (c) 2022 Clinical Oncohematology