Improved outcome with hematopoietic stem cell transplantation in a poor prognostic subgroup of infants with mixed-lineage-leukemia (MLL)-rearranged acute lymphoblastic leukemia: results from the Interfant-99 Study
Identifieur interne : 007796 ( Main/Exploration ); précédent : 007795; suivant : 007797Improved outcome with hematopoietic stem cell transplantation in a poor prognostic subgroup of infants with mixed-lineage-leukemia (MLL)-rearranged acute lymphoblastic leukemia: results from the Interfant-99 Study
Auteurs : Georg Mann [Autriche] ; Andishe Attarbaschi [Autriche] ; Martin Schrappe [Allemagne] ; Paola De Lorenzo [Italie] ; Christina Peters [Autriche] ; Ian Hann [Royaume-Uni] ; Giulio De Rossi [Italie] ; Maria Felice [Argentine] ; Birgitte Lausen [Norvège] ; Thierry Leblanc [France] ; Tomasz Szczepanski [Pologne] ; Alina Ferster [Belgique] ; Gritta Janka-Schaub [Allemagne] ; Jeffrey Rubnitz [États-Unis] ; Lewis B. Silverman [États-Unis] ; Jan Stary [République tchèque] ; Myriam Campbell [Chili] ; CHI KONG LI [Hong Kong] ; Ram Suppiah [Australie] ; Andrea Biondi [Italie] ; Ajay Vora [Royaume-Uni] ; Maria Grazia Valsecchi [Italie] ; Rob Pieters [Pays-Bas]Source :
- Blood [ 0006-4971 ] ; 2010.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Cellule souche.
English descriptors
- KwdEn :
Abstract
To define a role for hematopoietic stem cell transplantation (HSCT) in infants with acute lymphoblastic leukemia and rearrangements of the mixed-lineage-leukemia gene (MLL+), we compared the outcome of MLL+ patients from trial Interfant-99 who either received chemotherapy only or HSCT. Of 376 patients with a known MLL status in the trial, 297 (79%) were MLL+. Among the 277 of 297 MLL+ patients (93%) in first remission (CR), there appeared to be a significant difference in disease-free survival (adjusted by waiting time to HSCT) between the 37 (13%) who received HSCT and the 240 (87%) who received chemotherapy only (P = .03). However, the advantage was restricted to a subgroup with 2 additional unfavorable prognostic features: age less than 6 months and either poor response to steroids at day 8 or leukocytes more than or equal to 300 g/L. Ninety-seven of 297 MLL+ patients (33%) had such high-risk criteria, with 87 achieving CR. In this group, HSCT was associated with a 64% reduction in the risk of failure resulting from relapse or death in CR (hazard ratio = 0.36, 95% confidence interval, 0.15-0.86). In the remaining patients, there was no advantage for HSCT over chemotherapy only. In summary, HSCT seems to be a valuable option for a subgroup of infant MLL+ acute lymphoblastic leukemia carrying further poor prognostic factors. The trial was registered at www. clinicaltrials.gov as #NCT00015873 and at www.controlled-trials.com as #IS-RCTN24251487.
Affiliations:
- Allemagne, Argentine, Australie, Autriche, Belgique, Chili, France, Hong Kong, Italie, Norvège, Pays-Bas, Pologne, Royaume-Uni, République tchèque, États-Unis
- Lombardie
- Milan
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Improved outcome with hematopoietic stem cell transplantation in a poor prognostic subgroup of infants with mixed-lineage-leukemia (MLL)-rearranged acute lymphoblastic leukemia: results from the Interfant-99 Study</title><author><name sortKey="Mann, Georg" sort="Mann, Georg" uniqKey="Mann G" first="Georg" last="Mann">Georg Mann</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Berlin-Frankfurt-Münster Study Group</s1><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Berlin-Frankfurt-Münster Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Attarbaschi, Andishe" sort="Attarbaschi, Andishe" uniqKey="Attarbaschi A" first="Andishe" last="Attarbaschi">Andishe Attarbaschi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Berlin-Frankfurt-Münster Study Group</s1><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 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uniqKey="Lausen B" first="Birgitte" last="Lausen">Birgitte Lausen</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Nordic Society of Pediatric Hematology and Oncology</s1><s3>NOR</s3><sZ>9 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>Nordic Society of Pediatric Hematology and Oncology</wicri:noRegion></affiliation></author><author><name sortKey="Leblanc, Thierry" sort="Leblanc, Thierry" uniqKey="Leblanc T" first="Thierry" last="Leblanc">Thierry Leblanc</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>French Acute Lymphoblastic Leukemia Study Group</s1><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>French Acute Lymphoblastic Leukemia Study Group</wicri:noRegion><wicri:noRegion>French Acute Lymphoblastic Leukemia Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Szczepanski, Tomasz" sort="Szczepanski, Tomasz" uniqKey="Szczepanski T" first="Tomasz" last="Szczepanski">Tomasz Szczepanski</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Polish Pediatric Leukemia and Lymphoma Study Group</s1><s3>POL</s3><sZ>11 aut.</sZ></inist:fA14><country>Pologne</country><wicri:noRegion>Polish Pediatric Leukemia and Lymphoma Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Ferster, Alina" sort="Ferster, Alina" uniqKey="Ferster A" first="Alina" last="Ferster">Alina Ferster</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Children's Leukemia Group</s1><s2>France</s2><s3>BEL</s3><sZ>12 aut.</sZ></inist:fA14><country>Belgique</country><wicri:noRegion>Children's Leukemia Group</wicri:noRegion></affiliation></author><author><name sortKey="Janka Schaub, Gritta" sort="Janka Schaub, Gritta" uniqKey="Janka Schaub G" first="Gritta" last="Janka-Schaub">Gritta Janka-Schaub</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Cooperative Acute Lymphoblastic Leukemia Study Group</s1><s3>DEU</s3><sZ>13 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Cooperative Acute Lymphoblastic Leukemia Study Group</wicri:noRegion><wicri:noRegion>Cooperative Acute Lymphoblastic Leukemia Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Rubnitz, Jeffrey" sort="Rubnitz, Jeffrey" uniqKey="Rubnitz J" first="Jeffrey" last="Rubnitz">Jeffrey Rubnitz</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>St Jude Children's Research Hospital</s1><s2>Memphis, TN</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>St Jude Children's Research Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Silverman, Lewis B" sort="Silverman, Lewis B" uniqKey="Silverman L" first="Lewis B." last="Silverman">Lewis B. Silverman</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Dana-Farber Cancer Institute ALL Consortium</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Dana-Farber Cancer Institute ALL Consortium</wicri:noRegion></affiliation></author><author><name sortKey="Stary, Jan" sort="Stary, Jan" uniqKey="Stary J" first="Jan" last="Stary">Jan Stary</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Czech Pediatric Haematology</s1><s3>CZE</s3><sZ>16 aut.</sZ></inist:fA14><country>République tchèque</country><wicri:noRegion>Czech Pediatric Haematology</wicri:noRegion></affiliation></author><author><name sortKey="Campbell, Myriam" sort="Campbell, Myriam" uniqKey="Campbell M" first="Myriam" last="Campbell">Myriam Campbell</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Program Infantil Nacional de Drogas Antineoplásicas</s1><s3>CHL</s3><sZ>17 aut.</sZ></inist:fA14><country>Chili</country><wicri:noRegion>Program Infantil Nacional de Drogas Antineoplásicas</wicri:noRegion></affiliation></author><author><name sortKey="Chi Kong Li" sort="Chi Kong Li" uniqKey="Chi Kong Li" last="Chi Kong Li">CHI KONG LI</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Hong Kong Pediatric Hematology and Oncology Study Group</s1><s3>HKG</s3><sZ>18 aut.</sZ></inist:fA14><country>Hong Kong</country><wicri:noRegion>Hong Kong Pediatric Hematology and Oncology Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Suppiah, Ram" sort="Suppiah, Ram" uniqKey="Suppiah R" first="Ram" last="Suppiah">Ram Suppiah</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Australian and New Zealand Children's Haematology and Oncology Study Group</s1><s3>AUS</s3><sZ>19 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Australian and New Zealand Children's Haematology and Oncology Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Biondi, Andrea" sort="Biondi, Andrea" uniqKey="Biondi A" first="Andrea" last="Biondi">Andrea Biondi</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Associazione Italiana Ematologia Oncologia Pediatrica</s1><s3>ITA</s3><sZ>7 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Associazione Italiana Ematologia Oncologia Pediatrica</wicri:noRegion></affiliation></author><author><name sortKey="Vora, Ajay" sort="Vora, Ajay" uniqKey="Vora A" first="Ajay" last="Vora">Ajay Vora</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>United Kingdom Children's Cancer Study Group</s1><s3>GBR</s3><sZ>6 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>United Kingdom Children's Cancer Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Grazia Valsecchi, Maria" sort="Grazia Valsecchi, Maria" uniqKey="Grazia Valsecchi M" first="Maria" last="Grazia Valsecchi">Maria Grazia Valsecchi</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Interfant-99 Trial Data Center, Department of Clinical Medicine and Prevention, University of Milano-Bicocca</s1><s2>Milan</s2><s3>ITA</s3><sZ>4 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Pieters, Rob" sort="Pieters, Rob" uniqKey="Pieters R" first="Rob" last="Pieters">Rob Pieters</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Dutch Childhood Oncology Study Group, Erasmus MC-Sophia Children's Hospital</s1><s3>NLD</s3><sZ>23 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Dutch Childhood Oncology Study Group, Erasmus MC-Sophia Children's Hospital</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">10-0485349</idno><date when="2010">2010</date><idno type="stanalyst">PASCAL 10-0485349 INIST</idno><idno type="RBID">Pascal:10-0485349</idno><idno type="wicri:Area/PascalFrancis/Corpus">002291</idno><idno type="wicri:Area/PascalFrancis/Curation">003D03</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">002334</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">002334</idno><idno type="wicri:doubleKey">0006-4971:2010:Mann G:improved:outcome:with</idno><idno type="wicri:Area/Main/Merge">007E02</idno><idno type="wicri:Area/Main/Curation">007796</idno><idno type="wicri:Area/Main/Exploration">007796</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Improved outcome with hematopoietic stem cell transplantation in a poor prognostic subgroup of infants with mixed-lineage-leukemia (MLL)-rearranged acute lymphoblastic leukemia: results from the Interfant-99 Study</title><author><name sortKey="Mann, Georg" sort="Mann, Georg" uniqKey="Mann G" first="Georg" last="Mann">Georg Mann</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Berlin-Frankfurt-Münster Study Group</s1><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Berlin-Frankfurt-Münster Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Attarbaschi, Andishe" sort="Attarbaschi, Andishe" uniqKey="Attarbaschi A" first="Andishe" last="Attarbaschi">Andishe Attarbaschi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Berlin-Frankfurt-Münster Study Group</s1><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Berlin-Frankfurt-Münster Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Schrappe, Martin" sort="Schrappe, Martin" uniqKey="Schrappe M" first="Martin" last="Schrappe">Martin Schrappe</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Berlin-Frankfurt-Münster Study Group</s1><s3>DEU</s3><sZ>3 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Berlin-Frankfurt-Münster Study Group</wicri:noRegion><wicri:noRegion>Berlin-Frankfurt-Münster Study Group</wicri:noRegion></affiliation></author><author><name sortKey="De Lorenzo, Paola" sort="De Lorenzo, Paola" uniqKey="De Lorenzo P" first="Paola" last="De Lorenzo">Paola De Lorenzo</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Interfant-99 Trial Data Center, Department of Clinical Medicine and Prevention, University of Milano-Bicocca</s1><s2>Milan</s2><s3>ITA</s3><sZ>4 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Peters, Christina" sort="Peters, Christina" uniqKey="Peters C" first="Christina" last="Peters">Christina Peters</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Berlin-Frankfurt-Münster Study Group</s1><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Berlin-Frankfurt-Münster Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Hann, Ian" sort="Hann, Ian" uniqKey="Hann I" first="Ian" last="Hann">Ian Hann</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>United Kingdom Children's Cancer Study Group</s1><s3>GBR</s3><sZ>6 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>United Kingdom Children's Cancer Study Group</wicri:noRegion></affiliation></author><author><name sortKey="De Rossi, Giulio" sort="De Rossi, Giulio" uniqKey="De Rossi G" first="Giulio" last="De Rossi">Giulio De Rossi</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Associazione Italiana Ematologia Oncologia Pediatrica</s1><s3>ITA</s3><sZ>7 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Associazione Italiana Ematologia Oncologia Pediatrica</wicri:noRegion></affiliation></author><author><name sortKey="Felice, Maria" sort="Felice, Maria" uniqKey="Felice M" first="Maria" last="Felice">Maria Felice</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Argentinean Group of Pediatric Hematology and Oncology</s1><s2>Buenos Aires</s2><s3>ARG</s3><sZ>8 aut.</sZ></inist:fA14><country>Argentine</country><wicri:noRegion>Argentinean Group of Pediatric Hematology and Oncology</wicri:noRegion></affiliation></author><author><name sortKey="Lausen, Birgitte" sort="Lausen, Birgitte" uniqKey="Lausen B" first="Birgitte" last="Lausen">Birgitte Lausen</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Nordic Society of Pediatric Hematology and Oncology</s1><s3>NOR</s3><sZ>9 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>Nordic Society of Pediatric Hematology and Oncology</wicri:noRegion></affiliation></author><author><name sortKey="Leblanc, Thierry" sort="Leblanc, Thierry" uniqKey="Leblanc T" first="Thierry" last="Leblanc">Thierry Leblanc</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>French Acute Lymphoblastic Leukemia Study Group</s1><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>French Acute Lymphoblastic Leukemia Study Group</wicri:noRegion><wicri:noRegion>French Acute Lymphoblastic Leukemia Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Szczepanski, Tomasz" sort="Szczepanski, Tomasz" uniqKey="Szczepanski T" first="Tomasz" last="Szczepanski">Tomasz Szczepanski</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Polish Pediatric Leukemia and Lymphoma Study Group</s1><s3>POL</s3><sZ>11 aut.</sZ></inist:fA14><country>Pologne</country><wicri:noRegion>Polish Pediatric Leukemia and Lymphoma Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Ferster, Alina" sort="Ferster, Alina" uniqKey="Ferster A" first="Alina" last="Ferster">Alina Ferster</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Children's Leukemia Group</s1><s2>France</s2><s3>BEL</s3><sZ>12 aut.</sZ></inist:fA14><country>Belgique</country><wicri:noRegion>Children's Leukemia Group</wicri:noRegion></affiliation></author><author><name sortKey="Janka Schaub, Gritta" sort="Janka Schaub, Gritta" uniqKey="Janka Schaub G" first="Gritta" last="Janka-Schaub">Gritta Janka-Schaub</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Cooperative Acute Lymphoblastic Leukemia Study Group</s1><s3>DEU</s3><sZ>13 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Cooperative Acute Lymphoblastic Leukemia Study Group</wicri:noRegion><wicri:noRegion>Cooperative Acute Lymphoblastic Leukemia Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Rubnitz, Jeffrey" sort="Rubnitz, Jeffrey" uniqKey="Rubnitz J" first="Jeffrey" last="Rubnitz">Jeffrey Rubnitz</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>St Jude Children's Research Hospital</s1><s2>Memphis, TN</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>St Jude Children's Research Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Silverman, Lewis B" sort="Silverman, Lewis B" uniqKey="Silverman L" first="Lewis B." last="Silverman">Lewis B. Silverman</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Dana-Farber Cancer Institute ALL Consortium</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Dana-Farber Cancer Institute ALL Consortium</wicri:noRegion></affiliation></author><author><name sortKey="Stary, Jan" sort="Stary, Jan" uniqKey="Stary J" first="Jan" last="Stary">Jan Stary</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Czech Pediatric Haematology</s1><s3>CZE</s3><sZ>16 aut.</sZ></inist:fA14><country>République tchèque</country><wicri:noRegion>Czech Pediatric Haematology</wicri:noRegion></affiliation></author><author><name sortKey="Campbell, Myriam" sort="Campbell, Myriam" uniqKey="Campbell M" first="Myriam" last="Campbell">Myriam Campbell</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Program Infantil Nacional de Drogas Antineoplásicas</s1><s3>CHL</s3><sZ>17 aut.</sZ></inist:fA14><country>Chili</country><wicri:noRegion>Program Infantil Nacional de Drogas Antineoplásicas</wicri:noRegion></affiliation></author><author><name sortKey="Chi Kong Li" sort="Chi Kong Li" uniqKey="Chi Kong Li" last="Chi Kong Li">CHI KONG LI</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Hong Kong Pediatric Hematology and Oncology Study Group</s1><s3>HKG</s3><sZ>18 aut.</sZ></inist:fA14><country>Hong Kong</country><wicri:noRegion>Hong Kong Pediatric Hematology and Oncology Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Suppiah, Ram" sort="Suppiah, Ram" uniqKey="Suppiah R" first="Ram" last="Suppiah">Ram Suppiah</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Australian and New Zealand Children's Haematology and Oncology Study Group</s1><s3>AUS</s3><sZ>19 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Australian and New Zealand Children's Haematology and Oncology Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Biondi, Andrea" sort="Biondi, Andrea" uniqKey="Biondi A" first="Andrea" last="Biondi">Andrea Biondi</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Associazione Italiana Ematologia Oncologia Pediatrica</s1><s3>ITA</s3><sZ>7 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Associazione Italiana Ematologia Oncologia Pediatrica</wicri:noRegion></affiliation></author><author><name sortKey="Vora, Ajay" sort="Vora, Ajay" uniqKey="Vora A" first="Ajay" last="Vora">Ajay Vora</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>United Kingdom Children's Cancer Study Group</s1><s3>GBR</s3><sZ>6 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>United Kingdom Children's Cancer Study Group</wicri:noRegion></affiliation></author><author><name sortKey="Grazia Valsecchi, Maria" sort="Grazia Valsecchi, Maria" uniqKey="Grazia Valsecchi M" first="Maria" last="Grazia Valsecchi">Maria Grazia Valsecchi</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Interfant-99 Trial Data Center, Department of Clinical Medicine and Prevention, University of Milano-Bicocca</s1><s2>Milan</s2><s3>ITA</s3><sZ>4 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Pieters, Rob" sort="Pieters, Rob" uniqKey="Pieters R" first="Rob" last="Pieters">Rob Pieters</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Dutch Childhood Oncology Study Group, Erasmus MC-Sophia Children's Hospital</s1><s3>NLD</s3><sZ>23 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Dutch Childhood Oncology Study Group, Erasmus MC-Sophia Children's Hospital</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Blood</title><title level="j" type="abbreviated">Blood</title><idno type="ISSN">0006-4971</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Blood</title><title level="j" type="abbreviated">Blood</title><idno type="ISSN">0006-4971</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute lymphocytic leukemia</term><term>C-Onc gene</term><term>Hematology</term><term>Hematopoietic cell</term><term>Hematopoietic stem cell transplantation</term><term>Infant</term><term>Mixed lineage</term><term>Prognosis</term><term>Protooncogene</term><term>Stem cell</term><term>Subgroup</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Pronostic</term><term>Cellule souche</term><term>Cellule hématopoïétique</term><term>Sous groupe</term><term>Nourrisson</term><term>Lignée mixte</term><term>Leucémie aiguë lymphoblastique</term><term>Protooncogène</term><term>Gène onc cellulaire</term><term>Hématologie</term><term>Gène MLL</term><term>Greffe de cellules souches hématopoïétiques</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Cellule souche</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To define a role for hematopoietic stem cell transplantation (HSCT) in infants with acute lymphoblastic leukemia and rearrangements of the mixed-lineage-leukemia gene (MLL<sup>+</sup>), we compared the outcome of MLL<sup>+</sup> patients from trial Interfant-99 who either received chemotherapy only or HSCT. Of 376 patients with a known MLL status in the trial, 297 (79%) were MLL<sup>+</sup>. Among the 277 of 297 MLL<sup>+</sup> patients (93%) in first remission (CR), there appeared to be a significant difference in disease-free survival (adjusted by waiting time to HSCT) between the 37 (13%) who received HSCT and the 240 (87%) who received chemotherapy only (P = .03). However, the advantage was restricted to a subgroup with 2 additional unfavorable prognostic features: age less than 6 months and either poor response to steroids at day 8 or leukocytes more than or equal to 300 g/L. Ninety-seven of 297 MLL<sup>+</sup> patients (33%) had such high-risk criteria, with 87 achieving CR. In this group, HSCT was associated with a 64% reduction in the risk of failure resulting from relapse or death in CR (hazard ratio = 0.36, 95% confidence interval, 0.15-0.86). In the remaining patients, there was no advantage for HSCT over chemotherapy only. In summary, HSCT seems to be a valuable option for a subgroup of infant MLL<sup>+</sup> acute lymphoblastic leukemia carrying further poor prognostic factors. The trial was registered at www. clinicaltrials.gov as #NCT00015873 and at www.controlled-trials.com as #IS-RCTN24251487.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Argentine</li><li>Australie</li><li>Autriche</li><li>Belgique</li><li>Chili</li><li>France</li><li>Hong Kong</li><li>Italie</li><li>Norvège</li><li>Pays-Bas</li><li>Pologne</li><li>Royaume-Uni</li><li>République tchèque</li><li>États-Unis</li></country><region><li>Lombardie</li></region><settlement><li>Milan</li></settlement></list><tree><country name="Autriche"><noRegion><name sortKey="Mann, Georg" sort="Mann, Georg" uniqKey="Mann G" first="Georg" last="Mann">Georg Mann</name></noRegion><name sortKey="Attarbaschi, Andishe" sort="Attarbaschi, Andishe" uniqKey="Attarbaschi A" first="Andishe" last="Attarbaschi">Andishe Attarbaschi</name><name sortKey="Peters, Christina" sort="Peters, Christina" uniqKey="Peters C" first="Christina" last="Peters">Christina Peters</name></country><country name="Allemagne"><noRegion><name sortKey="Schrappe, Martin" sort="Schrappe, Martin" uniqKey="Schrappe M" first="Martin" last="Schrappe">Martin Schrappe</name></noRegion><name sortKey="Janka Schaub, Gritta" sort="Janka Schaub, Gritta" uniqKey="Janka Schaub G" first="Gritta" last="Janka-Schaub">Gritta Janka-Schaub</name></country><country name="Italie"><region name="Lombardie"><name sortKey="De Lorenzo, Paola" sort="De Lorenzo, Paola" uniqKey="De Lorenzo P" first="Paola" last="De Lorenzo">Paola De Lorenzo</name></region><name sortKey="Biondi, Andrea" sort="Biondi, Andrea" uniqKey="Biondi A" first="Andrea" last="Biondi">Andrea Biondi</name><name sortKey="De Rossi, Giulio" sort="De Rossi, Giulio" uniqKey="De Rossi G" first="Giulio" last="De Rossi">Giulio De Rossi</name><name sortKey="Grazia Valsecchi, Maria" sort="Grazia Valsecchi, Maria" uniqKey="Grazia Valsecchi M" first="Maria" last="Grazia Valsecchi">Maria Grazia Valsecchi</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Hann, Ian" sort="Hann, Ian" uniqKey="Hann I" first="Ian" last="Hann">Ian Hann</name></noRegion><name sortKey="Vora, Ajay" sort="Vora, Ajay" uniqKey="Vora A" first="Ajay" last="Vora">Ajay Vora</name></country><country name="Argentine"><noRegion><name sortKey="Felice, Maria" sort="Felice, Maria" uniqKey="Felice M" first="Maria" last="Felice">Maria Felice</name></noRegion></country><country name="Norvège"><noRegion><name sortKey="Lausen, Birgitte" sort="Lausen, Birgitte" uniqKey="Lausen B" first="Birgitte" last="Lausen">Birgitte Lausen</name></noRegion></country><country name="France"><noRegion><name sortKey="Leblanc, Thierry" sort="Leblanc, Thierry" uniqKey="Leblanc T" first="Thierry" last="Leblanc">Thierry Leblanc</name></noRegion></country><country name="Pologne"><noRegion><name sortKey="Szczepanski, Tomasz" sort="Szczepanski, Tomasz" uniqKey="Szczepanski T" first="Tomasz" last="Szczepanski">Tomasz Szczepanski</name></noRegion></country><country name="Belgique"><noRegion><name sortKey="Ferster, Alina" sort="Ferster, Alina" uniqKey="Ferster A" first="Alina" last="Ferster">Alina Ferster</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Rubnitz, Jeffrey" sort="Rubnitz, Jeffrey" uniqKey="Rubnitz J" first="Jeffrey" last="Rubnitz">Jeffrey Rubnitz</name></noRegion><name sortKey="Silverman, Lewis B" sort="Silverman, Lewis B" uniqKey="Silverman L" first="Lewis B." last="Silverman">Lewis B. Silverman</name></country><country name="République tchèque"><noRegion><name sortKey="Stary, Jan" sort="Stary, Jan" uniqKey="Stary J" first="Jan" last="Stary">Jan Stary</name></noRegion></country><country name="Chili"><noRegion><name sortKey="Campbell, Myriam" sort="Campbell, Myriam" uniqKey="Campbell M" first="Myriam" last="Campbell">Myriam Campbell</name></noRegion></country><country name="Hong Kong"><noRegion><name sortKey="Chi Kong Li" sort="Chi Kong Li" uniqKey="Chi Kong Li" last="Chi Kong Li">CHI KONG LI</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Suppiah, Ram" sort="Suppiah, Ram" uniqKey="Suppiah R" first="Ram" last="Suppiah">Ram Suppiah</name></noRegion></country><country name="Pays-Bas"><noRegion><name sortKey="Pieters, Rob" sort="Pieters, Rob" uniqKey="Pieters R" first="Rob" last="Pieters">Rob Pieters</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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