TY - JOUR
T1 - Outcome of congenital acute lymphoblastic leukemia treated on the Interfant-99 protocol
AU - Van Der Linden, Marieke H.
AU - Valsecchi, Maria Grazia
AU - De Lorenzo, Paola
AU - Möricke, Anja
AU - Janka, Gritta
AU - Leblanc, Thierry M.
AU - Felice, Maria
AU - Biondi, Andrea
AU - Campbell, Myriam
AU - Hann, Ian
AU - Rubnitz, Jeffrey E.
AU - Stary, Jan
AU - Szczepanski, Tomasz
AU - Vora, Ajay
AU - Ferster, Alina
AU - Hovi, Liisa
AU - Silverman, Lewis B.
AU - Pieters, Rob
PY - 2009/10/29
Y1 - 2009/10/29
N2 - Acute lymphoblastic leukemia (ALL) diagnosed in the first month of life (congenital ALL) is very rare. Although congenital ALL is often assumed to be fatal, no studies have been published on outcome except for case reports. The present study reports the outcome of 30 patients with congenital ALL treated with the uniform Interfant-99 protocol, a hybrid regimen combining ALL treatment with elements designed for treatment of acute myeloid leukemia. Congenital ALL was characterized by a higher white blood cell count and a strong trend for higher incidence ofMLLrearrangements and CD10-negative B-lineageALLcompared with older infants. Induction failure rate was 13% and not significantly different from that in older infants (7%, P = .14), but relapse rate was significantly higher in congenital ALL patients (2-year cumulative incidence [SE] was 60.0 [9.3] vs 34.2 [2.3], P < .001). Two-year event-free survival and survival of congenital ALL patients treated with this protocol was 20% (SE 9.1%). Early death in complete remission and treatment delays resulting from toxicity were not different. The survival of 17% after last follow-up, combined with a toxicity profile comparable with that in older infants, justifies treating congenital ALL with curative intent. This trial was registered at www.clinicaltrials.gov as no. NCT 00015873, and at www.controlled-trials. com as no. ISRCTN24251487.
AB - Acute lymphoblastic leukemia (ALL) diagnosed in the first month of life (congenital ALL) is very rare. Although congenital ALL is often assumed to be fatal, no studies have been published on outcome except for case reports. The present study reports the outcome of 30 patients with congenital ALL treated with the uniform Interfant-99 protocol, a hybrid regimen combining ALL treatment with elements designed for treatment of acute myeloid leukemia. Congenital ALL was characterized by a higher white blood cell count and a strong trend for higher incidence ofMLLrearrangements and CD10-negative B-lineageALLcompared with older infants. Induction failure rate was 13% and not significantly different from that in older infants (7%, P = .14), but relapse rate was significantly higher in congenital ALL patients (2-year cumulative incidence [SE] was 60.0 [9.3] vs 34.2 [2.3], P < .001). Two-year event-free survival and survival of congenital ALL patients treated with this protocol was 20% (SE 9.1%). Early death in complete remission and treatment delays resulting from toxicity were not different. The survival of 17% after last follow-up, combined with a toxicity profile comparable with that in older infants, justifies treating congenital ALL with curative intent. This trial was registered at www.clinicaltrials.gov as no. NCT 00015873, and at www.controlled-trials. com as no. ISRCTN24251487.
UR - http://www.scopus.com/inward/record.url?scp=70449706226&partnerID=8YFLogxK
U2 - 10.1182/blood-2009-02-204214
DO - 10.1182/blood-2009-02-204214
M3 - Article
C2 - 19657114
AN - SCOPUS:70449706226
SN - 0006-4971
VL - 114
SP - 3764
EP - 3768
JO - Blood
JF - Blood
IS - 18
ER -