Improved Survival for Children and Adolescents With Acute Lymphoblastic Leukemia Between 1990 and 2005: A Report From the Children's Oncology Group
- Study type
- Observational study
- Study name
- COG ALL 1990–2005
- Design
- Population-based cohort study of patients enrolled in Children's Oncology Group (COG) acute lymphoblastic leukaemia clinical trials, comparing three time periods
- Sample size
- 21,626 patients
- Source
- JCO · 2012
In plain words
This study shows that the chance of survival for children and teenagers with acute lymphoblastic leukaemia rose markedly over the 15 years studied. Survival at 5 years went from about 84% to about 90%. This improvement was seen in most age and ethnic groups, but there was little change in infants.
Key results
Treatment arms and regimens
Patients enrolled in various COG trials in this period; regimens varied by protocol and risk group, and no single dose can be given.
Patients enrolled in various COG trials in this period; regimens varied by protocol and risk group.
Patients enrolled in various COG trials in this period; regimens varied by protocol and risk group.
Source of the regimen details: Multi-protocol cohort study; no single regimen (abstract of the paper)
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
People aged 0 to 22 years enrolled between 1990 and 2005 in Children's Oncology Group (COG) acute lymphoblastic leukaemia (ALL) clinical trials; this number was equivalent to 55.8% of the estimated ALL cases in people under 20 years living in the United States during this period.
Endpoints
Change in 5-year and 10-year survival over time, the association of these changes with clinical variables, and analysis of cause of death.
Safety and side effects
Detailed safety data are not reported in the abstract. In the cause-of-death analysis, deaths after relapse/disease progression decreased and toxicity-related deaths increased.
Clinical significance and place in guidelines
This report documents the continuing improvement in survival in childhood ALL in COG trials and shows that a substantial share of deaths (36%) occurs in children with standard risk; further improvement in outcome must therefore address both high-risk subgroups and groups with an excellent prognosis. The increase in toxic deaths is a reminder of the importance of supportive care. This study does not give specific treatment recommendations, and its status in clinical guidelines should be checked separately.
Limitations
Based on the abstract: this is a descriptive study based on patients enrolled in COG trials and covers 55.8% of estimated ALL cases. Survival in infants did not improve significantly. Details of the treatment regimens in each period are not given in the abstract.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.