Volumen: 20 # Number : 2
Publication Date : Mayo - Agosto Year: 2016
Comparative analysis between protocol Ib vs increased Ib
(Aug) in pediatric patients with intermediate and high risk
(IR and HR) acute lymphoblastic leukemia
Authors: Morán L, Wittmund L, Ferraro C, Prada S, Aversa L
Abstract: The outcome for children with acute lymphoblastic
leukemia (ALL) has improved with the use of postinduction
intensive chemotherapy regimens.
We evaluate clinical and hematological features,
outcome and toxicities developed in 96 patients
(p) with intermediate (IR) and high risk (HR) ALL
that randomized to Ib vs IbAug protocol between
06/2010 and 31/12/2014, that completed protocol I.
No differences were found in expected time protocol
duration when we compared Ib vs IbAug. There
were no differences in hematological, pancreatic and
neurological toxicities, hyperglycemia, infections,
febrile neutropenia, bleeding episodes, thrombosis,
stomatitis and L-asparaginase allergy. We found
significant differences in hepatic toxicity and
allergic reactions to peg-asparaginase in Ib vs IbAug
(15 p/32 p, p< 0,01; 4 p/13 p, p<0,01, respectively).
When we analyze HR group, the patients that
received Ib had lower overall survival (OS) (50% vs
80%, p=0.09).
Despite therapy intensification, there were no
differences between Ib and IbAug in duration and
delay to next phase. We found a higher incidence
of allergic reaction to peg-asparaginase and hepatic
toxicity in patients that received IbAug.
Key words: Acute lymphoblastic leukemia,
risk group,
childhood.
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