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Outcome of central nervous system relapses in childhood acute lymphoblastic leukaemia - prospective open cohort analyses of the ALLR3 trial

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اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • Contributors:
      Baer, M.
    • بيانات النشر:
      Public Library of Science
    • الموضوع:
      2014
    • Collection:
      The University of Adelaide: Digital Library
    • نبذة مختصرة :
      The outcomes of Central Nervous System (CNS) relapses in children with acute lymphoblastic leukaemia (ALL) treated in the ALL R3 trial, between January 2003 and March 2011 were analysed. Patients were risk stratified, to receive a matched donor allogeneic transplant or fractionated cranial irradiation with continued treatment for two years. A randomisation of Idarubicin with Mitoxantrone closed in December 2007 in favour of Mitoxantrone. The estimated 3-year progression free survival for combined and isolated CNS disease were 40.6% (25·1, 55·6) and 38.0% (26.2, 49.7) respectively. Univariate analysis showed a significantly better survival for age <10 years, progenitor-B cell disease, good-risk cytogenetics and those receiving Mitoxantrone. Adjusting for these variables (age, time to relapse, cytogenetics, treatment drug and gender) a multivariate analysis, showed a poorer outcome for those with combined CNS relapse (HR 2·64, 95% CI 1·32, 5·31, p = 0·006 for OS). ALL R3 showed an improvement in outcome for CNS relapses treated with Mitoxantrone compared to Idarubicin; a potential benefit for matched donor transplant for those with very early and early isolated-CNS relapses. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN45724312. ; Ashish Narayan Masurekar, Catriona A. Parker, ., Milensu Shanyinde, Anthony V. Moorman, Jeremy P. Hancock, Rosemary Sutton, Philip J. Ancliff, Mary Morgan, Nicholas J. Goulden, Chris Fraser, Peter M. Hoogerbrugge, Tamas Revesz, Philip J. Darbyshire, Shekhar Krishnan, Sharon B. Love, Vaskar Saha
    • File Description:
      application/pdf
    • ISSN:
      1932-6203
    • Relation:
      http://purl.org/au-research/grants/nhmrc/1024232; PLoS One, 2014; 9(10):e108107-1-e108107-13; http://hdl.handle.net/2440/94986; Revesz, T. [0000-0003-2501-0259]
    • الرقم المعرف:
      10.1371/journal.pone.0108107
    • Rights:
      © 2014 Masurekar et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    • الرقم المعرف:
      edsbas.AE13327