Treatment and endpoints. – AIEOP-BFM ALL – AIEOP-BFM ALL • Perspectives. ALL, acute lymphoblastic leukemia; MRD, minimal residual disease. Principal investigator of clinical trial. Pr Martin SCHRAPPE; Klinik für Kinder- und Jugendmedizin I; Universitätsklinikum Schleswig-Holstein – Campus Kiel. Blood ; doi: .. Accordingly, in the AIEOP-BFM ALL study, these 2 groups of patients.

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International collaborative treatment protocol for children and adolescents with acute lymphoblastic leukaemia. Assessment of optimal thresholds for MRD prediction of relapse. For these items you should use the filters and not add them to your search terms in the text field.

Trials with results Wll without results. International, multicenter, randomized clinical trial Phase III. The number of patients and 5 year relapse-free survival percentage are given for each subgroup.

The day 15 MRD analysis was performed retrospectively using the more sensitive or 20009 first marker used for stratification. Receiver operating characteristic ROC analysis was performed using Medcalc to estimate the all discriminatory thresholds for MRD [15]. The value of MRD at even earlier timepoints in induction day 15 or day 19 in the identification of patients with particularly favourable outcomes has already been established for MRD measured by quantitative flow cytometry [6][7] and in small PCR-MRD studies [8] — [10].

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 properly credited.

English translations are still in development. Discussion This study has shown in children treated for acute lymphoblastic leukaemia that the rapid clearance of bone marrow disease is associated with a low relapse rate and conversely that patients with high levels of disease have higher rates of relapse.

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Support Center Support Center. Obtained funding MN MH. International collaborative treatment protocol for children and adolescents with acute lymphoblastic leukemia Medical condition: Earlier stratification of high risk patients in clinical trials may be beneficial in enabling novel treatments to be trialled on patients who achieve only a shallow remission at the end of induction with reductions in MRD providing a surrogate end-point.

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How to search [pdf]. It is also important to note that these criteria identified 13 of the aieop-nfm precursor B-ALL patients originally stratified as high risk al to high MRD at day These effects were not apparent in the 30 T-ALL patients but were maintained in the whole cohort.

We therefore arbitrarily defined an extra MRD threshold for precursor B-ALL patients at both day 15 and day 33 in order to distinguish 3 risk groups with a reasonable number of patients Figure 4C, 4D. Trials shown on current page Selected Trials only.

National Center for Biotechnology InformationU. In the case of non-availability of at least two sensitive MRD markers sensitivity at least 10 -4 lal, MRD risk group stratification can also be based on only one sensitive marker. Kaplan Meier Survival curves and Cox-Mantel log rank analysis was performed using Graphic Pad Prism and Medcalc was used for the Cox proportional hazard model of multivariate analysis.

Pediatr Blood Cancer Information not available in EudraCT. No results available EudraCT Number: Better tailoring of treatments to suit different subsets of ALL patients could lead to further improvements in morbidity and mortality for ALL patients. Previous studies and the patient characteristics shown in Table 1suggested that other factors may influence relapse outcomes.

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This aieop-bmf has been cited by other articles in PMC.

In Table 1the characteristics of the whole group of patients are compared with the 89 patients excluded due to lack of day 15 sample or suitable assay; with the patients included and the 53 included patients al relapsed.

J Clin Oncol Identification of a new poor early response group within medium risk for MRD risk stratification.

AIEOP-BFM ALL 2009

This study has shown in children treated for acute lymphoblastic leukaemia that the rapid clearance of bone marrow disease is associated with a low relapse rate and conversely that patients with high levels of disease have higher rates of relapse. Clonal rearrangements of immunoglobulin and T-cell receptor genes had previously been identified for aieop-bffm patient by PCR and sequencing.

The separate analysis of precursor B and T-ALL patients in BFM protocols has improved our understanding of response to therapy and risk [5][12][15][19]. The medium risk group were patients not qualifying for either standard or high risk. Date study was submitted in EudraCT.

While there is good reason to delay stratification for T-ALL patients in whom the day 79 MRD results provide better prognostic discrimination [12] our analyses suggest that risk assessment sll precursor B-ALL can be improved by the combined use of day 15 and day 33 MRD results to identify the PER group. Standard risk and medium risk patients were treated uniformly according to the common control arm in BFM ALL and high risk patients were assigned to treatment with novel high risk chemotherapy blocks [4].