Summary Anthracyclines are used to treat childhood acute lymphoblastic leukaemia (ALL) but non-randomized studies suggest that cardiotoxicity may be a problem. Individual patient data from trials in childhood ALL that randomized anthracyclines or methods of reducing cardiotoxicity were analysed by standard meta-analysis methods. Results were grouped and combined according to: addition of an anthracycline to standard therapy, type of anthracycline, mode of administration, and the use of a cardioprotectant. Data from 958 patients in 4 trials, recruiting between 1972 and 1984, showed that addition of an anthracycline reduced bone marrow relapse and, non-significantly, non-bone marrow relapse, resulting in an increased relapse-free interval. However there was a non-significant increase in induction failures, and in deaths in first remission. Event-free survival at 5 years was 56·7% with anthracycline versus 52·8% without (Odds Ratio = 0·91; 95% Confidence Interval = 0·76-1·10; P = 0·3). There were no significant differences found in other treatment comparisons. The limited data from trials did not demonstrate differences in clinically evident cardiotoxicity. Anthracyclines are effective against bone marrow relapse but have not been shown to significantly increase event free survival in childhood ALL. The evidence on type of anthracycline, method of administration or use of cardioprotectant was insufficient to be able to rule out important differences. © 2009 Blackwell Publishing Ltd.

Masera, G., Valsecchi, M., & Childhood Acute Lymphoblastic Leukaemia Collaborative, G. (2009). Beneficial and harmful effects of anthracyclines in the treatment of childhood acute lymphoblastic leukaemia: a systematic review and meta-analysis. BRITISH JOURNAL OF HAEMATOLOGY, 145(3), 376-388 [10.1111/j.1365-2141.2009.07624.x].

Beneficial and harmful effects of anthracyclines in the treatment of childhood acute lymphoblastic leukaemia: A systematic review and meta-analysis

MASERA, GIUSEPPE;VALSECCHI, MARIA GRAZIA;
2009

Abstract

Summary Anthracyclines are used to treat childhood acute lymphoblastic leukaemia (ALL) but non-randomized studies suggest that cardiotoxicity may be a problem. Individual patient data from trials in childhood ALL that randomized anthracyclines or methods of reducing cardiotoxicity were analysed by standard meta-analysis methods. Results were grouped and combined according to: addition of an anthracycline to standard therapy, type of anthracycline, mode of administration, and the use of a cardioprotectant. Data from 958 patients in 4 trials, recruiting between 1972 and 1984, showed that addition of an anthracycline reduced bone marrow relapse and, non-significantly, non-bone marrow relapse, resulting in an increased relapse-free interval. However there was a non-significant increase in induction failures, and in deaths in first remission. Event-free survival at 5 years was 56·7% with anthracycline versus 52·8% without (Odds Ratio = 0·91; 95% Confidence Interval = 0·76-1·10; P = 0·3). There were no significant differences found in other treatment comparisons. The limited data from trials did not demonstrate differences in clinically evident cardiotoxicity. Anthracyclines are effective against bone marrow relapse but have not been shown to significantly increase event free survival in childhood ALL. The evidence on type of anthracycline, method of administration or use of cardioprotectant was insufficient to be able to rule out important differences. © 2009 Blackwell Publishing Ltd.
Articolo in rivista - Articolo scientifico
Scientifica
childhood acute lymphoblastic leukaemia
English
376
388
CALLCG Participating groups and trialists: Ankara, Turkey: S Yetgin, NY Özbek; Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP): G Masera, MG Valsecchi; Athens, Greece: Dacou-Voutetakis; Berlin-Frankfurt-Muenster (BFM), Germany: L Loening, M Schrappe, M Zimmermann, G Henze, A von Stackelberg; BFM Austria: H Gadner, G Mann, A Attarbaschi; Brazilian Cooperative ALL trials (GBTLI), Brazil: SR Brandalise; Children's Oncology Group (COG), USA: WL Carroll, P Gaynon, JM Boyett, J Nachman, M Devidas, HN Sather; Cooperative Acute Lymphoblastic Leukaemia Group (COALL), Germany: E Escherich, G Janka; Dana Farber Cancer Institute (DFCI), USA: RD Gelber, SE Sallan; Dutch Childhood Oncology Group, (DCOG): R Pieters, M Bierings, WA Kamps; European Organisation for Research on Treatment of Cancer (EORTC): J Otten, S Suciu; Faculdade de Medicina da UFMG, Brazil: MB Viana; French ALL Cooperative group: A Baruchel, M Auclerc; Instituto Nacional de Enfermedades Neoplasicas (INEN), Peru: C Perez, A Solidaro; Israel National Study group: B Stark, D Steinberg; Japanese Children's Cancer and Leukemia Group (JCCLSG): S Koizumi, M Tsurusawa; Jena University, Germany: F Zintl, I Schiller; Kyushu-Yamaguchi Children's Cancer Study Group, Japan: A Matsuzaki; Medical Research Council (MRC), UK: TOB Eden, JS Lilleyman, S Richards; Memorial and Sloan Kettering Cancer Center (MSKCC), USA: PG Steinherz, L Steinherz; New Delhi, India: V Kochupillai, S Bakhshi; Programa para el Tratamiento de Hemopatías Malignas (PETHEMA), Spain: JJ Ortega; Pediatric Oncology Group (POG), USA: J Nachman; Southwest Oncology Group (SWOG), USA: FR Appelbaum; St Jude Children's Research Hospital, Memphis, USA: JM Boyett, C Cheng, D Pei, CH Pui; Tata Memorial Hospital, Bombay, India: P Kukure; Tokyo Children's Cancer Study Group, Japan: S Nakazawa, M Tsuchida; Secretariat: T Elphinstone, V Evans, L Gettins, C Hicks, L MacKinnon, P Morris, S Richards, R Wade. Contributors Writing committee: Professor TOB Eden, Paediatric and Adolescent Oncology Unit, University of Manchester, Wilmslow Road, Manchester, M20 4BX. Professor R Pieters, Erasmus RC, Sophia Children's Hospital, PO Box 2060, Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
Masera, G., Valsecchi, M., & Childhood Acute Lymphoblastic Leukaemia Collaborative, G. (2009). Beneficial and harmful effects of anthracyclines in the treatment of childhood acute lymphoblastic leukaemia: a systematic review and meta-analysis. BRITISH JOURNAL OF HAEMATOLOGY, 145(3), 376-388 [10.1111/j.1365-2141.2009.07624.x].
Masera, G; Valsecchi, M; Childhood Acute Lymphoblastic Leukaemia Collaborative, G
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/7013
Citazioni
  • Scopus 22
  • ???jsp.display-item.citation.isi??? 16
Social impact