# Interfant-99: a treatment protocol for infants under one year with acute lymphoblastic leukaemia

Source: https://onco.cc/key-papers/paper-interfant-99-lancet-2007/  
OnCo record `paper-interfant-99-lancet-2007` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The first international infant leukaemia trial established a hybrid chemotherapy backbone and showed that a late intensification course did not help, while identifying age under six months, KMT2A rearrangement and poor steroid response as the key risk factors.

## Summary

International observational study and randomised trial of 482 infants with ALL treated with a hybrid protocol including elements of ALL and AML therapy, with randomisation to a late intensification course or not.

Four-year event-free survival was 47 percent overall with no benefit from late intensification; KMT2A rearrangement, age under six months, high white count and poor prednisone response defined high-risk infants with event-free survival around 20 percent.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2007
- DOI: 10.1016/S0140-6736(07)61126-X
- Authors: Pieters R, Schrappe M, De Lorenzo P, et al.
- Findings: Four-year event-free survival 47 percent overall.; No benefit from late intensification (hazard ratio 1.07).
- What it means: Interfant-99 defined the risk groups and backbone used in Interfant-06 and Interfant-21.
- Caveats: Outcomes remained poor for high-risk infants, motivating later immunotherapy.

## Sources

- Lancet 2007: https://doi.org/10.1016/S0140-6736(07)61126-X
- PubMed: https://pubmed.ncbi.nlm.nih.gov/17658395/

## Connected records

- cancers: [Infant acute lymphoblastic leukaemia (KMT2A-rearranged, under one year)](https://onco.cc/cancers/all-infant/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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