Background
Acute B‐cell leukemia (B‐ALL) is a rare form of pediatric leukemia characterized by a very high‐proliferation index, rapid clinical progression, and a high frequency of central nervous system (CNS) involvement. Commonly, it is treated in the clinical trials for Burkitt lymphoma, of which it represents the leukemic counterpart.
Procedure
Children with B‐ALL diagnosed between 1988 and 1999 were enrolled in the AIEOP‐8805 protocol. Treatment included six high‐dose chemotherapy courses. No prophylactic CNS irradiation was administered.
Results
Sixty‐five consecutive patients were enrolled in the study. L3 morphology was observed in 57 of 65 patients (88%). Twenty‐five children (38%) had tumor mass in addition to massive bone marrow infiltration; 11 children (17%) had CNS disease at diagnosis. Sixty‐two patients obtained complete morphological remission of which 13 suffered a relapse, including 3 with initial CNS involvement. Ten‐year overall survival and event‐free survival were 77% and 75%, respectively. Neither relevant long‐term toxicity nor second malignancies were observed.
Conclusions
The AIEOP‐8805 confirmed that short high‐dose chemotherapy is highly effective for the treatment of B‐ALL without significant long‐term adverse sequelae. Therapy modifications to reduce relapse rate, such as the use of anti‐CD20 monoclonal antibody and more effective CNS treatment, are being tested. Pediatr Blood Cancer 2011;56:544–550. © 2010 Wiley‐Liss, Inc.