Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO)
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field In a multinational, population-based study from the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden), 2648 children below 15 y of age were diagnosed with acute lymphobla...
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/49001 2023-05-15T16:52:20+02:00 Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO) Gustafsson, G Kreuger, A Clausen, N Garwicz, S Kristinsson, J Lie, S O Moe, P J Perkkiö, M Yssing, M Saarinen-Pihkala, U M Childhood Cancer Research Unit, Karolinska Hospital, Stockholm, Sweden. 2009-02-12 http://hdl.handle.net/2336/49001 https://doi.org/10.1111/j.1651-2227.1998.tb00923.x en eng http://dx.doi.org/10.1111/j.1651-2227.1998.tb00923.x Acta Paediatr. 1998, 87(11):1151-61 0803-5253 9846917 doi:10.1111/j.1651-2227.1998.tb00923.x http://hdl.handle.net/2336/49001 Acta paediatrica (Oslo, Norway : 1992) Antineoplastic Combined Chemotherapy Protocols Child Preschool Clinical Protocols Female Humans Infant Male Precursor Cell Lymphoblastic Leukemia-Lymphoma Probability Prognosis Retrospective Studies Scandinavia Survival Analysis Treatment Outcome Article 2009 ftlandspitaliuni https://doi.org/10.1111/j.1651-2227.1998.tb00923.x 2022-05-29T08:21:16Z To access publisher full text version of this article. Please click on the hyperlink in Additional Links field In a multinational, population-based study from the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden), 2648 children below 15 y of age were diagnosed with acute lymphoblastic leukaemia (ALL) in the years 1981-1996. The annual incidence was 3.9/100000 children and was stable throughout the study period. The development from regional or national protocols to common Nordic treatment protocols for all risk groups was completed in 1992 through a successive intensification of therapy, based on multidrug chemotherapy including pulses of methotrexate in high doses and avoidance of cranial irradiation in most children. For children with non-B-cell ALL (n=2602), the event-free survival (p-EFS) increased from 0.53+/-0.02 (diagnosed 7/81-6/86) to 0.67+/-0.02 (7/86-12/91) to 0.78+/-0.02 (1/92-12/96). The corresponding p-EFS values at 5 y were 0.57, 0.70 and 0.78, respectively. The main improvements were seen in the group of children with non-high risk leukaemia, with 5-y p-EFS values increasing from 0.60 to 0.76 and 0.85 for the three periods. In high-risk patients, progress has been moderate, especially in children with high white blood cell values at diagnosis. During the last 5-y period, only 10% of the patients received cranial irradiation in first remission while 90% of the patients received high doses of cytostatic infusions (methotrexate isolated or combined with cytarabinoside) and multiple intrathecal injections of methotrexate as CNS-adjusted treatment without any indication of an increased CNS relapse rate. Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Norway Acta Paediatrica 87 11 1151 1161 |
institution |
Open Polar |
collection |
Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
Antineoplastic Combined Chemotherapy Protocols Child Preschool Clinical Protocols Female Humans Infant Male Precursor Cell Lymphoblastic Leukemia-Lymphoma Probability Prognosis Retrospective Studies Scandinavia Survival Analysis Treatment Outcome |
spellingShingle |
Antineoplastic Combined Chemotherapy Protocols Child Preschool Clinical Protocols Female Humans Infant Male Precursor Cell Lymphoblastic Leukemia-Lymphoma Probability Prognosis Retrospective Studies Scandinavia Survival Analysis Treatment Outcome Gustafsson, G Kreuger, A Clausen, N Garwicz, S Kristinsson, J Lie, S O Moe, P J Perkkiö, M Yssing, M Saarinen-Pihkala, U M Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO) |
topic_facet |
Antineoplastic Combined Chemotherapy Protocols Child Preschool Clinical Protocols Female Humans Infant Male Precursor Cell Lymphoblastic Leukemia-Lymphoma Probability Prognosis Retrospective Studies Scandinavia Survival Analysis Treatment Outcome |
description |
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field In a multinational, population-based study from the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden), 2648 children below 15 y of age were diagnosed with acute lymphoblastic leukaemia (ALL) in the years 1981-1996. The annual incidence was 3.9/100000 children and was stable throughout the study period. The development from regional or national protocols to common Nordic treatment protocols for all risk groups was completed in 1992 through a successive intensification of therapy, based on multidrug chemotherapy including pulses of methotrexate in high doses and avoidance of cranial irradiation in most children. For children with non-B-cell ALL (n=2602), the event-free survival (p-EFS) increased from 0.53+/-0.02 (diagnosed 7/81-6/86) to 0.67+/-0.02 (7/86-12/91) to 0.78+/-0.02 (1/92-12/96). The corresponding p-EFS values at 5 y were 0.57, 0.70 and 0.78, respectively. The main improvements were seen in the group of children with non-high risk leukaemia, with 5-y p-EFS values increasing from 0.60 to 0.76 and 0.85 for the three periods. In high-risk patients, progress has been moderate, especially in children with high white blood cell values at diagnosis. During the last 5-y period, only 10% of the patients received cranial irradiation in first remission while 90% of the patients received high doses of cytostatic infusions (methotrexate isolated or combined with cytarabinoside) and multiple intrathecal injections of methotrexate as CNS-adjusted treatment without any indication of an increased CNS relapse rate. |
author2 |
Childhood Cancer Research Unit, Karolinska Hospital, Stockholm, Sweden. |
format |
Article in Journal/Newspaper |
author |
Gustafsson, G Kreuger, A Clausen, N Garwicz, S Kristinsson, J Lie, S O Moe, P J Perkkiö, M Yssing, M Saarinen-Pihkala, U M |
author_facet |
Gustafsson, G Kreuger, A Clausen, N Garwicz, S Kristinsson, J Lie, S O Moe, P J Perkkiö, M Yssing, M Saarinen-Pihkala, U M |
author_sort |
Gustafsson, G |
title |
Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO) |
title_short |
Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO) |
title_full |
Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO) |
title_fullStr |
Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO) |
title_full_unstemmed |
Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO) |
title_sort |
intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the nordic experience of 2648 patients diagnosed between 1981 and 1996. nordic society of paediatric haematology and oncology (nopho) |
publishDate |
2009 |
url |
http://hdl.handle.net/2336/49001 https://doi.org/10.1111/j.1651-2227.1998.tb00923.x |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://dx.doi.org/10.1111/j.1651-2227.1998.tb00923.x Acta Paediatr. 1998, 87(11):1151-61 0803-5253 9846917 doi:10.1111/j.1651-2227.1998.tb00923.x http://hdl.handle.net/2336/49001 Acta paediatrica (Oslo, Norway : 1992) |
op_doi |
https://doi.org/10.1111/j.1651-2227.1998.tb00923.x |
container_title |
Acta Paediatrica |
container_volume |
87 |
container_issue |
11 |
container_start_page |
1151 |
op_container_end_page |
1161 |
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1766042477835321344 |