Change search
ReferencesLink to record
Permanent link

Direct link
Relapsed childhood acute lymphoblastic leukemia in the Nordic countries: prognostic factors, treatment and outcome
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Show others and affiliations
2016 (English)In: Haematologica, ISSN 0390-6078, E-ISSN 1592-8721, Vol. 101, no 1, 68-76 p.Article in journal (Refereed) PublishedText
Abstract [en]

Relapse is the main reason for treatment failure in childhood acute lymphoblastic leukemia. Despite improvements in the up-front therapy, survival after relapse is still relatively poor, especially for high-risk relapses. The aims of this study were to assess outcomes following acute lymphoblastic leukemia relapse after common initial Nordic Society of Paediatric Haematology and Oncology protocol treatment; to validate currently used risk stratifications, and identify additional prognostic factors for overall survival. Altogether, 516 of 2735 patients (18.9%) relapsed between 1992 and 2011 and were included in the study. There were no statistically significant differences in outcome between the up-front protocols or between the relapse protocols used, but an improvement over time was observed. The 5-year overall survival for patients relapsing in the period 2002-2011 was 57.5 +/- 3.4%, but 44.7 +/- 3.2% (P<0.001) if relapse occurred in the period 1992-2001. Factors independently predicting mortality after relapse included short duration of first remission, bone marrow involvement, age ten years or over, unfavorable cytogenetics, and Down syndrome. T-cell immunophenotype was not an independent prognostic factor unless in combination with hyperleukocytosis at diagnosis. The outcome for early combined pre-B relapses was unexpectedly poor (5-year overall survival 38.0 +/- 10.6%), which supports the notion that these patients need further risk adjustment. Although survival outcomes have improved over time, the development of novel approaches is urgently needed to increase survival in relapsed childhood acute lymphoblastic leukemia.

Place, publisher, year, edition, pages
2016. Vol. 101, no 1, 68-76 p.
Keyword [en]
leukemia, treatment outcome, scandinavian and nordic countries
National Category
Pediatrics Cancer and Oncology
URN: urn:nbn:se:umu:diva-118803DOI: 10.3324/haematol.2015.131680ISI: 000371220700021PubMedID: 26494838OAI: diva2:918342
Available from: 2016-04-11 Created: 2016-04-04 Last updated: 2016-04-11Bibliographically approved

Open Access in DiVA

fulltext(1412 kB)27 downloads
File information
File name FULLTEXT01.pdfFile size 1412 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Forestier, Erik
By organisation
In the same journal
PediatricsCancer and Oncology

Search outside of DiVA

GoogleGoogle Scholar
Total: 27 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 34 hits
ReferencesLink to record
Permanent link

Direct link