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Blood, 1 September 2008, Vol. 112, No. 5, pp. 1646-1654. Prepublished online as a Blood First Edition Paper on May 23, 2008; DOI 10.1182/blood-2008-01-130237. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-01-130237v1 112/5/1646    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Stock, W. Articles by Nachman, J. PubMed PubMed Citation Articles by Stock, W. Articles by Nachman, J. Related Collections Neoplasia Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS What determines the outcomes for adolescents and young adults with acute lymphoblastic leukemia treated on cooperative group protocols? A comparison of Children's Cancer Group and Cancer and Leukemia Group B studies Wendy Stock1, Mei La2, Ben Sanford3, Clara D. Bloomfield4, James W. Vardiman5, Paul Gaynon6, Richard A. Larson1, and James Nachman7 1 Section of Hematology/Oncology, Department of Medicine, University of Chicago and University of Chicago Cancer Research Center, IL; 2 Statistical Center, Children's Oncology Group (COG), Arcadia, CA; 3 Statistical Center, Cancer and Leukemia Group B, Durham, NC; 4 Department of Medicine, Arthur G. James Cancer Hospital and Research Institute, Columbus, OH; 5 Department of Pathology, University of Chicago, IL; 6 Department of Pediatrics, Children's Hospital of Los Angeles, CA; and 7 Department of Pediatrics, University of Chicago, IL We performed a retrospective comparison of presenting features, planned treatment, complete remission (CR) rate, and outcome of 321 adolescents and young adults (AYAs) ages 16 to 20 years with newly diagnosed acute lymphoblastic leukemia (ALL) who were treated on consecutive trials in either the Children's Cancer Group (CCG) or the Cancer and Leukemia Group B (CALGB) from 1988 to 2001. CR rates were identical, 90% for both CALGB and CCG AYAs. CCG AYAs had a 63% event-free survival (EFS) and 67% overall survival (OS) at 7 years in contrast to the CALGB AYAs, in which 7-year EFS was only 34% (P < .001; relative hazard rate [RHR] = 2.2) and OS was 46% (P < .001; RHR = 1.9). While CALGB AYAs aged 16 to 17 years achieved similar outcomes to all CCG AYAs with a 7-year EFS of 55%, the EFS for 18- to 20-year-old CALGB patients was only 29%. Comparison of the regimens showed that CCG AYAs received earlier and more intensive central nervous system prophylaxis and higher cumulative doses of nonmyelosuppressive agents. There were no differences in outcomes of those who reached maintenance therapy on time compared with those who were delayed. Based on these observations, a prospective study for AYAs with ALL using the more successful approach of the CCG has been initiated. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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