دورية أكاديمية
Outcomes in Children, Adolescents, and Young Adults With Down Syndrome and ALL: A Report From the Children's Oncology Group.
| العنوان: | Outcomes in Children, Adolescents, and Young Adults With Down Syndrome and ALL: A Report From the Children's Oncology Group. |
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| المؤلفون: | Rabin KR; Baylor College of Medicine, Houston, TX., Devidas M; St Jude Children's Research Hospital, Memphis, TN., Chen Z; University of Florida, Gainesville, FL., Ji L; University of Southern California, Los Angeles, CA., Kairalla J; University of Florida, Gainesville, FL., Hitzler JK; The Hospital for Sick Children, Toronto, ON., Yang JJ; St Jude Children's Research Hospital, Memphis, TN., Carroll AJ; University of Alabama at Birmingham, Birmingham, AL., Heerema NA; The Ohio State University, Columbus, OH., Borowitz MJ; Johns Hopkins University, Baltimore, MD., Wood BL; University of Southern California, Los Angeles, CA., Roberts KG; St Jude Children's Research Hospital, Memphis, TN., Mullighan CG; St Jude Children's Research Hospital, Memphis, TN., Harvey RC; University of New Mexico, Albuquerque, NM., Chen IM; University of New Mexico, Albuquerque, NM., Willman CL; Mayo Clinic Comprehensive Cancer Center, Rochester, MN., Reshmi SC; Nationwide Children's Hospital, Columbus, OH., Gastier-Foster JM; Baylor College of Medicine, Houston, TX., Bhojwani D; University of Southern California, Los Angeles, CA., Rheingold SR; Children's Hospital of Philadelphia, Philadelphia, PA., Maloney KW; University of Colorado, Aurora, CO., Mattano LA; HARP Pharma Consulting, Mystic, CT., Larsen EC; Maine Children's Cancer Program, Scarborough, ME., Schore RJ; Children's National Medical Center, Washington, DC., Burke MJ; Children's Hospital of Wisconsin, Milwaukee, WI., Salzer WL; US Army Medical Research and Materiel Command, Fort Detrick, MD., Winick NJ; University of Texas Southwestern, Dallas, TX., Carroll WL; New York University, New York, NY., Raetz EA; New York University, New York, NY., Loh ML; University of Washington, Seattle, WA., Hunger SP; Children's Hospital of Philadelphia, Philadelphia, PA., Angiolillo AL; Servier Pharmaceuticals, Boston, MA. |
| المصدر: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2024 Jan 10; Vol. 42 (2), pp. 218-227. Date of Electronic Publication: 2023 Oct 27. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Society of Clinical Oncology Country of Publication: United States NLM ID: 8309333 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-7755 (Electronic) Linking ISSN: 0732183X NLM ISO Abbreviation: J Clin Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2003- : Alexandria, VA : American Society of Clinical Oncology Original Publication: New York, N.Y. : Grune & Stratton, c1983- |
| مواضيع طبية MeSH: | Down Syndrome*/complications , Down Syndrome*/therapy, Child ; Humans ; Adolescent ; Young Adult ; Infant ; Child, Preschool ; Adult ; Treatment Outcome ; Disease-Free Survival ; Neoplasm Recurrence, Local/complications ; Recurrence ; Neoplasm, Residual |
| مستخلص: | Purpose: Patients with Down syndrome (DS) and B-ALL experience increased rates of relapse, toxicity, and death. We report results for patients with DS B-ALL enrolled on Children's Oncology Group trials between 2003 and 2019. Methods: We analyzed data for DS (n = 743) and non-DS (n = 20,067) patients age 1-30 years on four B-ALL standard-risk (SR) and high-risk trials. Results: Patients with DS exhibited more frequent minimal residual disease (MRD) ≥0.01% at end induction (30.8% v 21.5%; P < .001). This difference persisted at end consolidation only in National Cancer Institute (NCI) high-risk patients (34.0% v 11.7%; P < .0001). Five-year event-free survival (EFS) and overall survival (OS) were significantly poorer for DS versus non-DS patients overall (EFS, 79.2% ± 1.6% v 87.5% ± 0.3%; P < .0001; OS, 86.8% ± 1.4% v 93.6% ± 0.2%; P < .0001), and within NCI SR and high-risk subgroups. Multivariable Cox regression analysis of the DS cohort for risk factors associated with inferior EFS identified age >10 years, white blood count >50 × 10 3 /μL, and end-induction MRD ≥0.01%, but not cytogenetics or CRLF2 overexpression. Patients with DS demonstrated higher 5-year cumulative incidence of relapse (11.5% ± 1.2% v 9.1% ± 0.2%; P = .0008), death in remission (4.9% ± 0.8% v 1.7% ± 0.1%; P < .0001), and induction death (3.4% v 0.8%; P < .0001). Mucositis, infections, and hyperglycemia were significantly more frequent in all patients with DS, while seizures were more frequent in patients with DS on high-risk trials (4.1% v 1.8%; P = .005). Conclusion: Patients with DS-ALL exhibit an increased rate of relapse and particularly of treatment-related mortality. Novel, less-toxic therapeutic strategies are needed to improve outcomes. |
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| معلومات مُعتمدة: | U24 CA196173 United States CA NCI NIH HHS; R01 CA249867 United States CA NCI NIH HHS; U10 CA098543 United States CA NCI NIH HHS; U10 CA180899 United States CA NCI NIH HHS; U10 CA180886 United States CA NCI NIH HHS; U10 CA098413 United States CA NCI NIH HHS; U24 CA114766 United States CA NCI NIH HHS |
| سلسلة جزيئية: | ClinicalTrials.gov NCT00103285; NCT01190930; NCT02883049; NCT00075725 |
| تواريخ الأحداث: | Date Created: 20231027 Date Completed: 20240108 Latest Revision: 20240201 |
| رمز التحديث: | 20240201 |
| مُعرف محوري في PubMed: | PMC10824380 |
| DOI: | 10.1200/JCO.23.00389 |
| PMID: | 37890117 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1527-7755 |
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| DOI: | 10.1200/JCO.23.00389 |