Research Article
BibTex RIS Cite

Comparison of augmented Berlin-Frankfurt-Münster (BFM) and BFM 2000 treatment protocols in children diagnosed with high-risk acute lymphoblastic leukemia

Year 2024, EARLY ONLINE, 1 - 9
https://doi.org/10.18621/eurj.1509117

Abstract

Objectives: The main purpose of this study is comparing the augmented Berlin-Frankfurt-Münster (BFM) and BFM 2000 treatment protocols applied to pediatric patients diagnosed with high-risk acute lymphoblastic leukemia (ALL) in our clinic in different years in terms of relapse incidence and survival rates.

Methods: When evaluated all patients considering the Children's Oncology Group (COG) criteria, 53 of our patients who were in the medium or high risk group according to the BFM 2000 protocol and were in the high risk group received treatment with Augmented BFM protocol and 17 of them received the BFM 2000 protocol. Age, gender, bone pathology, physical examination, hepatomegaly, splenomegaly, lymphadenopathy, presence of bleeding, hemogram values, immunophenotype, 8th, 14th and 33rd day treatment response, presence of translocation, central nervous system (CNS), extramedullary involvement, risk group, presence of relapse, time to relapse, follow-up period and hospital stay until maintenance treatment were examined.

Results: Event-Free Survival (EFS) and Overall Survival (OS) values of patients were 83.6% and 90.1%, respectively. While EFS was 89.4% and OS was 90.6% in the group receiving the Augmented BFM treatment protocol, EFS was calculated as 71.7% and OS was 88.2% in those receiving the BFM-2000 treatment protocol. Accordingly, when the EFS values of those who received the Augmented BFM treatment protocol were compared with those who received BFM-2000, statistically significant values were found (P<0.01).

Conclusions: It was observed that the augmented BFM treatment protocol was more protective against relapses and shortened the duration of hospitalization compared to the BFM 2000 treatment protocol.

References

  • 1. Ağaoğlu L. Neoplastik hastalıklar. Pediatri. Cilt 2, 4. Baskı. İstanbul: Nobel Tıp Kitabevleri; 2010: pp.1359-1373.
  • 2. Soycan YL. Akut Lenfoblastik Lösemi; Tanı, Klinik in Pediyatrik Hematoloji. 1. Baskı. İstanbul: İstanbul Medikal Yayıncılık; 2011: pp.597-611.
  • 3. Miranda-Filho A, Piñeros M, Ferlay J, Soerjomataram I, Monnereau A, Bray F. Epidemiological patterns of leukaemia in 184 countries: a population-based study. Lancet Haematol. 2018;5(1):e14-e24. doi: 10.1016/S2352-3026(17)30232-6.
  • 4. Hayashi H, Makimoto A, Yuza Y. Treatment of Pediatric Acute Lymphoblastic Leukemia: A Historical Perspective. Cancers (Basel). 2024;16(4):723. doi: 10.3390/cancers16040723.
  • 5. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023-1075. doi: 10.1016/S0140-6736(17)33326-3.
  • 6. Salzer WL, Devidas M, Carroll WL, et al. Long-term results of the pediatric oncology group studies for childhood acute lymphoblastic leukemia 1984-2001: a report from the children's oncology group. Leukemia. 2010;24(2):355-370. doi: 10.1038/leu.2009.261.
  • 7. Hunger SP. Development and refinement of augmented treatment regimens for pediatric high-risk acute lymphoblastic leukemia. Am Soc Clin Oncol Educ Book. 2012:611-615. doi: 10.14694/EdBook_AM.2012.32.180.
  • 8. Seibel NL. Acute lymphoblastic leukemia: an historical perspective. Hematology Am Soc Hematol Educ Program. 2008:365. doi: 10.1182/asheducation-2008.1.365.
  • 9. Bowman WP, Larsen EL, Devidas M, et al. Augmented therapy improves outcome for pediatric high risk acute lymphocytic leukemia: results of Children's Oncology Group trial. Pediatr Blood Cancer. 2011;57(4):569-577. doi: 10.1002/pbc.22944.
  • 10. Reaman GH, Sposto R, Sensel MG, et al. Treatment outcome and prognostic factors for infants with acute lymphoblastic leukemia treated on two consecutive trials of the Children's Cancer Group. J Clin Oncol 1999;17(2):445-455. doi: 10.1200/JCO.1999.17.2.445.
  • 11. Xue YJ, Cheng YF, Lu AD, et al. Allogeneic Hematopoietic Stem Cell Transplantation, Especially Haploidentical, May Improve Long-Term Survival for High-Risk Pediatric Patients with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in the Tyrosine Kinase Inhibitor Era. Biol Blood Marrow Transplant. 2019;25(8):1611-1620. doi: 10.1016/j.bbmt.2018.12.007.
  • 12. Pui CH, Relling MV, Downing JR. Acute lymphoblastic leukemia. N Engl J Med. 2004;350(15):1535-1548. doi: 10.1056/NEJMra023001.
  • 13.Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33. doi: 10.3322/caac.21654.
  • 14. Talleur AC, Maude SL. What is the role for HSCT or immunotherapy in pediatric hypodiploid B-cell acute lymphoblastic leukemia? Hematology Am Soc Hematol Educ Program. 2024;2020(1):508-511. doi: 10.1182/hematology.2020000162.
  • 15. Ishii E, Eguchi H, Matsuzaki A, et al. Outcome of acute lymphoblastic leukemia in children with AL90 regimen: impact of response to treatment and sex difference on prognostic factors. Med Pediatr Oncol. 2001;37(1):10-19. doi: 10.1002/mpo.1156.
  • 16. Tekgündüz E, Demir M, Akpınar S. [Acute Lymphoblastic Leukemia; Prognostic Factors’ Perspective]. Uluslararası Hematoloji-Onkoloji Dergisi. 2010:20(2):57-66. [Article in Turkish]
  • 17. Carroll WL, Bhojwani D, Min DJ, et al. Pediatric acute lymphoblastic leukemia. Hematology Am Soc Hematol Educ Program. 2003:102-131. doi: 10.1182/asheducation-2003.1.102.
  • 18. Alves GV, Fernandes AL, Freire JM, et al. Flow cytometry immunophenotyping evaluation in acute lymphoblastic leukemia: correlation to factors affecting clinic outcome. J Clin Lab Anal. 2012;26(6):431-440. doi: 10.1002/jcla.21540.
  • 19. Ruggero D, Baccarani M, Gobbi M, Tura S. Adult acute lymphoblastic leukaemia: study of 32 patients and analysis of prognostic factors. Scand J Haematol. 1979;22(2):154-164. doi: 10.1111/j.1600-0609.1979.tb00416.x.
  • 20. Celkan T. Çocukluk çağı lenfoblastik lösemisi. Klinik Gelişim. 2007;20(2):14-25.
  • 21. Harousseau JL, Tobelem G, Schaison G, et al. High risk acute lymphocytic leukemia: a study of 141 cases with initial white blood cell counts over 100,000/cu mm. Cancer. 1980;46(9):1996-2003.doi:10.1002/1097-0142(19801101)46:9<1996::aid-cncr2820460917>3.0.co;2-r.
  • 22. Seibel NL, Steinherz PG, Sather HN, et al. Early postinduction intensification therapy improves survival for children and adolescents with high-risk acute lymphoblastic leukemia: a report from the Children's Oncology Group. Blood. 2008;111(5):2548-2555. doi: 10.1182/blood-2007-02-070342.
  • 23. Lanzkowsky P. Lanzkowsky's Manual of Pediatric Hematology and Oncology. Sixth edition. San Diego: Elsevier; 2016: pp. 367-389.
  • 24. Zhang AL, Chen XJ, Zou Y, et al. [Clinical features and prognosis of children with acute lymphoblastic leukemia and different platelet levels]. Zhongguo Dang Dai Er Ke Za Zhi. 2019;21(8):766-771. doi: 10.7499/j.issn.1008-8830.2019.08.006. [Article in Chinese]
  • 25. Biondi A, Cario G, De Lorenzo P, et al. Long-term follow up of pediatric Philadelphia positive acute lymphoblastic leukemia treated with the EsPhALL2004 study: high white blood cell count at diagnosis is the strongest prognostic factor. Haematologica. 2019;104(1):e13-e16. doi: 10.3324/haematol.2018.199422.
Year 2024, EARLY ONLINE, 1 - 9
https://doi.org/10.18621/eurj.1509117

Abstract

References

  • 1. Ağaoğlu L. Neoplastik hastalıklar. Pediatri. Cilt 2, 4. Baskı. İstanbul: Nobel Tıp Kitabevleri; 2010: pp.1359-1373.
  • 2. Soycan YL. Akut Lenfoblastik Lösemi; Tanı, Klinik in Pediyatrik Hematoloji. 1. Baskı. İstanbul: İstanbul Medikal Yayıncılık; 2011: pp.597-611.
  • 3. Miranda-Filho A, Piñeros M, Ferlay J, Soerjomataram I, Monnereau A, Bray F. Epidemiological patterns of leukaemia in 184 countries: a population-based study. Lancet Haematol. 2018;5(1):e14-e24. doi: 10.1016/S2352-3026(17)30232-6.
  • 4. Hayashi H, Makimoto A, Yuza Y. Treatment of Pediatric Acute Lymphoblastic Leukemia: A Historical Perspective. Cancers (Basel). 2024;16(4):723. doi: 10.3390/cancers16040723.
  • 5. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023-1075. doi: 10.1016/S0140-6736(17)33326-3.
  • 6. Salzer WL, Devidas M, Carroll WL, et al. Long-term results of the pediatric oncology group studies for childhood acute lymphoblastic leukemia 1984-2001: a report from the children's oncology group. Leukemia. 2010;24(2):355-370. doi: 10.1038/leu.2009.261.
  • 7. Hunger SP. Development and refinement of augmented treatment regimens for pediatric high-risk acute lymphoblastic leukemia. Am Soc Clin Oncol Educ Book. 2012:611-615. doi: 10.14694/EdBook_AM.2012.32.180.
  • 8. Seibel NL. Acute lymphoblastic leukemia: an historical perspective. Hematology Am Soc Hematol Educ Program. 2008:365. doi: 10.1182/asheducation-2008.1.365.
  • 9. Bowman WP, Larsen EL, Devidas M, et al. Augmented therapy improves outcome for pediatric high risk acute lymphocytic leukemia: results of Children's Oncology Group trial. Pediatr Blood Cancer. 2011;57(4):569-577. doi: 10.1002/pbc.22944.
  • 10. Reaman GH, Sposto R, Sensel MG, et al. Treatment outcome and prognostic factors for infants with acute lymphoblastic leukemia treated on two consecutive trials of the Children's Cancer Group. J Clin Oncol 1999;17(2):445-455. doi: 10.1200/JCO.1999.17.2.445.
  • 11. Xue YJ, Cheng YF, Lu AD, et al. Allogeneic Hematopoietic Stem Cell Transplantation, Especially Haploidentical, May Improve Long-Term Survival for High-Risk Pediatric Patients with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in the Tyrosine Kinase Inhibitor Era. Biol Blood Marrow Transplant. 2019;25(8):1611-1620. doi: 10.1016/j.bbmt.2018.12.007.
  • 12. Pui CH, Relling MV, Downing JR. Acute lymphoblastic leukemia. N Engl J Med. 2004;350(15):1535-1548. doi: 10.1056/NEJMra023001.
  • 13.Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33. doi: 10.3322/caac.21654.
  • 14. Talleur AC, Maude SL. What is the role for HSCT or immunotherapy in pediatric hypodiploid B-cell acute lymphoblastic leukemia? Hematology Am Soc Hematol Educ Program. 2024;2020(1):508-511. doi: 10.1182/hematology.2020000162.
  • 15. Ishii E, Eguchi H, Matsuzaki A, et al. Outcome of acute lymphoblastic leukemia in children with AL90 regimen: impact of response to treatment and sex difference on prognostic factors. Med Pediatr Oncol. 2001;37(1):10-19. doi: 10.1002/mpo.1156.
  • 16. Tekgündüz E, Demir M, Akpınar S. [Acute Lymphoblastic Leukemia; Prognostic Factors’ Perspective]. Uluslararası Hematoloji-Onkoloji Dergisi. 2010:20(2):57-66. [Article in Turkish]
  • 17. Carroll WL, Bhojwani D, Min DJ, et al. Pediatric acute lymphoblastic leukemia. Hematology Am Soc Hematol Educ Program. 2003:102-131. doi: 10.1182/asheducation-2003.1.102.
  • 18. Alves GV, Fernandes AL, Freire JM, et al. Flow cytometry immunophenotyping evaluation in acute lymphoblastic leukemia: correlation to factors affecting clinic outcome. J Clin Lab Anal. 2012;26(6):431-440. doi: 10.1002/jcla.21540.
  • 19. Ruggero D, Baccarani M, Gobbi M, Tura S. Adult acute lymphoblastic leukaemia: study of 32 patients and analysis of prognostic factors. Scand J Haematol. 1979;22(2):154-164. doi: 10.1111/j.1600-0609.1979.tb00416.x.
  • 20. Celkan T. Çocukluk çağı lenfoblastik lösemisi. Klinik Gelişim. 2007;20(2):14-25.
  • 21. Harousseau JL, Tobelem G, Schaison G, et al. High risk acute lymphocytic leukemia: a study of 141 cases with initial white blood cell counts over 100,000/cu mm. Cancer. 1980;46(9):1996-2003.doi:10.1002/1097-0142(19801101)46:9<1996::aid-cncr2820460917>3.0.co;2-r.
  • 22. Seibel NL, Steinherz PG, Sather HN, et al. Early postinduction intensification therapy improves survival for children and adolescents with high-risk acute lymphoblastic leukemia: a report from the Children's Oncology Group. Blood. 2008;111(5):2548-2555. doi: 10.1182/blood-2007-02-070342.
  • 23. Lanzkowsky P. Lanzkowsky's Manual of Pediatric Hematology and Oncology. Sixth edition. San Diego: Elsevier; 2016: pp. 367-389.
  • 24. Zhang AL, Chen XJ, Zou Y, et al. [Clinical features and prognosis of children with acute lymphoblastic leukemia and different platelet levels]. Zhongguo Dang Dai Er Ke Za Zhi. 2019;21(8):766-771. doi: 10.7499/j.issn.1008-8830.2019.08.006. [Article in Chinese]
  • 25. Biondi A, Cario G, De Lorenzo P, et al. Long-term follow up of pediatric Philadelphia positive acute lymphoblastic leukemia treated with the EsPhALL2004 study: high white blood cell count at diagnosis is the strongest prognostic factor. Haematologica. 2019;104(1):e13-e16. doi: 10.3324/haematol.2018.199422.
There are 25 citations in total.

Details

Primary Language English
Subjects Pediatric Hematology and Oncology
Journal Section Original Articles
Authors

Samet Özer 0000-0003-0880-7215

Fatma Leyla Ağaoğlu 0009-0006-4835-5822

Zeynep Karakaş 0000-0002-8835-3235

Ayşegül Ünüvar 0000-0002-4730-7697

Ömer Devecioğlu 0000-0001-6378-0516

Early Pub Date August 6, 2024
Publication Date
Submission Date July 5, 2024
Acceptance Date August 4, 2024
Published in Issue Year 2024 EARLY ONLINE

Cite

AMA Özer S, Ağaoğlu FL, Karakaş Z, Ünüvar A, Devecioğlu Ö. Comparison of augmented Berlin-Frankfurt-Münster (BFM) and BFM 2000 treatment protocols in children diagnosed with high-risk acute lymphoblastic leukemia. Eur Res J. Published online August 1, 2024:1-9. doi:10.18621/eurj.1509117

e-ISSN: 2149-3189 


The European Research Journal, hosted by Turkish JournalPark ACADEMIC, is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

by-nc-nd.png

2024