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Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®)

Health Professional Version
Last Modified: 04/04/2014

Changes to this Summary (04/04/2014)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Risk-based Treatment Assignment

Added text to state that multiple reports have documented the adverse prognostic significance of an IKZF1 deletion, and most studies have reported that this deletion is an independent predictor of poor outcome on multivariate analyses (cited Dörge et al. and van der Veer et al. as references 168 and 169, respectively).

Added text to state that point mutations in kinase genes other than JAK1 and JAK2 are uncommon in CRLF2-overexpressing cases.

Added text about the results of several retrospective studies that suggest that CRLF2 abnormalities may have adverse prognostic significance on univariate analyses, and that most studies do not find it to be an independent predictor of outcome.

Added text to state that polymorphic variants involving the reduced folate carrier and methotrexate metabolism have been linked to toxicity and outcome (cited Radtke et al. as reference 183).

Added Marshall et al. as reference 189.

Postinduction Treatment for Childhood ALL

Added text to state that in a Dutch and Australian trial of 111 children with high-risk features or high minimal residual disease (MRD), patients received three novel intensive chemotherapy agents followed by allogeneic transplantation. Thirty of these patients were high risk by MRD and had a 5-year event-free survival (EFS) of 64% (cited Marshall et al. as reference 33).

Treatment of Relapsed Childhood ALL

Added text to state that in a study of induction therapy comprising intensive asparaginase with prednisone, vincristine, and doxorubicin for patients with first relapse, the second complete remission rate was 86% for those receiving PEG-L-asparaginase and 81% for those receiving E.coli asparaginase (cited Kelly et al. as reference 36 and level of evidence 2Di).

This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.