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Rigshospitalet - a part of Copenhagen University Hospital

T-cell acute lymphoblastic leukemia in patients 1-45 years treated with the pediatric NOPHO ALL2008 protocol

Research output: Contribution to journalJournal articleResearchpeer-review

  • P Quist-Paulsen
  • N Toft
  • M Heyman
  • J Abrahamsson
  • L Griškevičius
  • H Hallböök
  • Ó G Jónsson
  • K Palk
  • G Vaitkeviciene
  • K Vettenranta
  • A Åsberg
  • T L Frandsen
  • S Opdahl
  • H V Marquart
  • S Siitonen
  • L T Osnes
  • M Hultdin
  • U M Overgaard
  • U Wartiovaara-Kautto
  • K Schmiegelow
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The NOPHO ALL2008 is a population-based study using an unmodified pediatric protocol in patients 1-45 years of age with acute lymphoblastic leukemia. Patients with T-ALL were given a traditional pediatric scheme if fast responding (minimal residual disease (MRD) < 0.1% day 29), or intensive block-based chemotherapy if slow responding (MRD > 0.1% day 29). Both treatment arms included pediatric doses of high-dose methotrexate and asparaginase. If MRD ≥ 5% on day 29 or ≥0.1% after consolidation, patients were assigned to allogeneic hematopoietic stem cell transplantation. The 5-year overall survival of the 278 T-ALL patients was 0.75 (95% CI 0.69-0.81), being 0.82 (0.74-0.88) for patients 1.0-9.9 years, 0.76 (0.66-0.86) for those 10.0-17.9 years, and 0.65 (0.55-0.75) for the older patients. The risk of death in first remission was significantly higher in adults (12%) compared with the 1-9 years group (4%). The MRD responses in the three age groups were similar, and only a nonsignificant increase in relapse risk was found in adults. In conclusion, an unmodified pediatric protocol in patients 1-45 years is effective in all age groups. The traditional pediatric treatment schedule was safe for all patients, but the intensive block therapy led to a high toxic death rate in adults.

Original languageEnglish
Issue number2
Pages (from-to)347-357
Number of pages11
Publication statusPublished - Feb 2020

ID: 59004656