Outcomes following induction failure in Japanese children with acute lymphoblastic leukemia.

Abstract

The characteristics and prognosis of Japanese children with acute lymphoblastic leukemia (ALL) who fail to achieve complete remission after remission induction chemotherapy (i.e., experience induction failure) are poorly understood. Therefore, we retrospectively analyzed data of patients enrolled in Japanese clinical trials for newly diagnosed ALL between 1996 and 2009. Among 4956 participants, 89 (1.8%) experienced induction failure. With a 6.0-year median follow-up, the 5-year overall survival rate of the entire cohort was 43.0% ± 5.5%. Survival rates did not differ between patients with B-cell precursor ALL (BCP-ALL) and T-cell ALL (T-ALL). In multivariate analysis, day 15 M3 marrow (bone marrow blast count ≥ 25%) was significantly correlated with poorer survival in the whole or BCP-ALL cohorts. In T-ALL, age < 6 years was significantly associated with poor survival. However, due to the small sample size, this correlation must be further investigated. Most T-ALL and BCR-ABL-positive BCP-ALL patients underwent allogeneic stem cell transplantation (allo-SCT). Survival rates did not differ between BCR-ABL-negative BCP-ALL patients who did and did not undergo allo-SCT, possibly due to the inclusion of lower-risk patients in the latter group. In conclusion, the induction failure rate and survival after diagnosis of induction failure in our study were comparable to previously reported figures.

• Authors: Chihaya Imai, Atsushi Sato, Mitsuteru Hiwatari, Yasuto Shimomura, Toshinori Hori, Souichi Suenobu, Toshihiko Imamura, Junichi Hara, Daisuke Hasegawa, Hiroyuki Takahashi, Kunihiko Moriya, Saori Katayama, Daisuke Tomizawa, Hiroshi Moritake, Takashi Taga, Keizo Horibe, Katsuyoshi Koh, Atsushi Manabe, Yasuhiro Okamoto
• Journal: International journal of hematology (Int J Hematol) Vol. 118 Issue 1 Pg. 99-106 (Jul 2023) ISSN: 1865-3774 [Electronic] Japan
• PMID: 37037958 (Publication Type: Journal Article)
• Copyright: © 2023. Japanese Society of Hematology.

Chemical References

• Fusion Proteins, bcr-abl

Topics

• Humans
• Child
• Treatment Outcome
• Fusion Proteins, bcr-abl
• Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
• Retrospective Studies
• East Asian People
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy)
• Prognosis
• Hematopoietic Stem Cell Transplantation
• Remission Induction
• Precursor B-Cell Lymphoblastic Leukemia-Lymphoma