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Results of Dana-Farber Cancer Institute Consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1981–1995)

Leukemia volume 14, pages 2247–2256 (2000)Cite this article

Abstract

The Dana-Farber Cancer Institute (DFCI) ALL consortium has been conducting clinical trials in childhood acute lymphoblastic leukemia (ALL) since 1981. The treatment backbone has included intensive, multi-agent remission induction, early intensification with weekly, high-dose asparaginase, cranial radiation for the majority of patients, frequent vincristine/ corticosteroid pulses during post-remission therapy, and for high-risk patients, doxorubicin during intensification. Between 1981 and 1995, 1255 children with newly diagnosed ALL were evaluated on four consecutive protocols: 81-01 (1981–1985), 85-01 (1985–1987), 87-01 (1987–1991) and 91-01 (1991–1995). The 5-year event-free survival (EFS) rates (± standard error) for all patients by protocol were as follows: 74 ± 3% (81-01), 78 ± 3% (85-01), 77 ± 2% (87-01) and 83 ± 2% (91-01). The 5-year EFS rates ranged from 78 to 85% for patients with B-progenitor phenotype retrospectively classified as NCI standard-risk, 63–82% for NCI high-risk B-progenitor patients, and 70–79% for patients with T cell phenotype. Results of randomized studies revealed that neither high-dose methotrexate during induction (protocol 87-01) nor high-dose 6-mercaptopurine during intensification (protocol 91-01) were associated with improvement in EFS compared with standard doses. Current studies continue to focus on improving efficacy while minimizing acute and late toxicities.

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Acknowledgements

This study was supported in part by grants from the National Institute of Health (CA 68484 and CA 06516). We thank the patients, families, physicians, nurses, data managers and all others who participated in these trials. We acknowledge the fundamental contributions of Molly Schwenn MD, as well as Kristin Barrett, Mia Donnelly, Jennifer Peppe, Joyce Su, Sharon Thornhill, Stacy Waters, Mary Young and Guangyong Zou.

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Authors and Affiliations

  1. Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    LB Silverman, VKimball Dalton & SE Sallan

  2. Division of Hematology/Oncology, Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    LB Silverman & SE Sallan

  3. Department of Biostatistical Science, Dana-Farber Cancer Institute, Boston, MA, USA

    L Declerck & RD Gelber

  4. Department of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA

    BL Asselin

  5. Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada

    RD Barr

  6. San Jorge Children's Hospital, Puerto Rico, USA

    LA Clavell

  7. Maine Children's Cancer Program, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME, USA

    CA Hurwitz

  8. Hospital Ste Justine, Montreal, Quebec, Canada

    A Moghrabi

  9. Le Centre Hospitalier de L'Université, Laval, Quebec, Canada

    Y Samson

  10. Department of Pediatrics, Oschner Medical Institutions, New Orleans, LA, USA

    MA Schorin

  11. Schneider Children's Hospital, New Hyde Park, NY, USA

    JM Lipton

  12. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    HJ Cohen

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Silverman, L., Declerck, L., Gelber, R. et al. Results of Dana-Farber Cancer Institute Consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1981–1995). Leukemia 14, 2247–2256 (2000). https://doi.org/10.1038/sj.leu.2401980

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