Comparative analysis of dexamethasone and methylprednisolone efficacy in induction therapy of childhood acute lymphoblastic leukemia: Results of ALL-MB 2002 multicenter study

N. B. Yudina; Юдина Наталья Борисовна; A. I. Karachunsky; Карачунский Александр Исаакович; Yu. V. Rumyantseva; Румянцева Юлия Васильевна; S. N. Lagoiko; Лагойко Светлана Николаевна; Gesche Tallen; Tallen G. .; O. V. Aleinikova; Алейникова Ольга Витальевна; O. I. Bydanov; Быданов Олег Иванович; N. V. Korepanova; Корепанова Наталья Владимировна; E. G. Mansurova; Мансурова Екатерина Геннадьевна; L. V. Baidun; Байдун Людмила Васильевна; T. V. Nasedkina; Наседкина Татьяна Васильевна; A. . Von Stackelberg; Von Stackelberg A. .; G. A. Novichkova; Новичкова Галина Анатольевна; A. A. Maschan; Масчан Алексей Александрович; D. V. Litvinov; Литвинов Дмитрий Витальевич; N. V. Myakova; Мякова Наталья Валерьевна; N. I. Ponomareva; Пономарева Наталья Игоревна; K. L. Kondratchik; Кондратчик Константин Леонидович; L. G. Fechina; Фечина Лариса Геннадьевна; O. V. Streneva; Стренева Ольга Владимировна; G. R. Sharapova; Шарапова Гюзель Рафаиловна; A. V. Shamardina; Шамардина Анастасия Вячеславовна; I. E. Gerbek; Гербек Инна Эмильевна; A. P. Shapochnik; Шапочник Александр Петрович; A. G. Rumyantsev; Румянцев Александр Григорьевич; G. . Henze; Henze G. .

doi:10.24287/1726-1708-2015-14-1-16-25

Comparative analysis of dexamethasone and methylprednisolone efficacy in induction therapy of childhood acute lymphoblastic leukemia: Results of ALL-MB 2002 multicenter study

Authors: Yudina N.B.¹, Karachunsky A.I.²^,3, Rumyantseva Y.V.²^,3, Lagoiko S.N.², Tallen G.⁴, Aleinikova O.V.⁵, Bydanov O.I.²^,5, Korepanova N.V.², Mansurova E.G.³, Baidun L.V.⁶, Nasedkina T.V.², Von Stackelberg A..⁴, Novichkova G.A.²^,3, Maschan A.A.²^,3, Litvinov D.V.²^,3, Myakova N.V.², Ponomareva N.I.⁶, Kondratchik K.L.³^,7, Fechina L.G.⁸, Streneva O.V.⁸, Sharapova G.R.⁹, Shamardina A.V.¹⁰, Gerbek I.E.¹¹, Shapochnik A.P.¹², Rumyantsev A.G.²^,3, Henze G..⁴
Affiliations:
1. Voronezh Regional Pediatric Clinical Hospital No 1
2. Federal Research Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev
3. Russian National Research Medical University named after N.I.Pirogov
4. Charité-Universitätsmedizin Berlin
5. Republican Center of Pediatric Oncology, Hematology, and Immunology
6. Russian Pediatric Clinical Hospital
7. Morozovskaya Pediatric Municipal Clinical Hospital
8. Regional Pediatric Clinical Hospital No 1
9. Nizhnevartovsk Regional Pediatric Clinical Hospital
10. Nizhny Novgorod Regional Pediatric Clinical Hospital
11. Tomsk Regional Clinical Hospital
12. Orenburg Regional Clinical Oncological Center
Issue: Vol 14, No 1 (2015)
Pages: 16-25
Section: ОСТРЫЙ ЛИМФОБЛАСТНЫЙ ЛЕЙКОЗ
Submitted: 19.09.2018
Published: 19.02.2015
URL: https://hemoncim.com/jour/article/view/86
DOI: https://doi.org/10.24287/1726-1708-2015-14-1-16-25
ID: 86

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This paper presents the results of randomized study of the efficacy of two glucocorticosteroids (GCS) in induction therapy of children and adolescents with acute lymphoblastic leukemia (ALL). A total of 1064 primary patients with ALL, aged 1-18 years, were registered from 18.04.2002 to 15.11.2006 in Russia and Belarus Republic. Randomization was carried out before induction therapy. The patients received the dexamethasone (Dexa; 6 mg/m²) “sleeve” of ALL-MB 2002 protocol (n = 539) or the methylprednisolone (MePred; 60 mg/m²) “sleeve” of the protocol (n = 525). The survival rates virtually did not differ: 10-year event-free survival (EFS) was 73 ± 2% in the Dexa group vs. 70 ± 2% in MePred group, p = 0.260; 10-year overall survival (OS) was 79 ± 2 and 77 ± 2%, respectively; p = 0.232; the incidence of relapses after ALL induction therapy by different GCS virtually did not differ. The incidence of isolated central nervous system relapses (1.7% in patients receiving Dexa and 3% in patients treated by MePred; p = 0.138) and of combined relapses with central nervous system involvement differed just negligibly (3.2% in Dexa group and 3.4% in MePred group; p = 0.937). The induction mortality was also similar (3.2% in Dexa group and 3.8% in MePred group; p = 0.677). Retrospective comparison in different age groups showed predominant efficacy of Dexa in children under 14 years of age. This fact deserves further research in prospective randomized multicenter studies.

Keywords

дети, острый лимфобластный лейкоз, глюкокортикостероиды, дексаметазон, метилпреднизолон, терапия, индукция, токсичность, children, acute lymphoblastic leukemia, glucocorticosteroids, dexamethasone, methylprednisolone, therapy, induction therapy, toxicity

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Comparative analysis of dexamethasone and methylprednisolone efficacy in induction therapy of childhood acute lymphoblastic leukemia: Results of ALL-MB 2002 multicenter study

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About the authors

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