AALL0434: nelarabine in newly diagnosed T-cell acute lymphoblastic leukaemia in children and young adults
Adding the T-cell-specific drug nelarabine to intensive chemotherapy improved disease-free survival in childhood T-cell acute lymphoblastic leukaemia and cut central nervous system relapses, in the largest T-ALL trial ever run.
Overview
Phase 3 trial of 1,895 patients with T-ALL of whom 1,562 were randomised in a factorial design to Capizzi or high-dose methotrexate and, for intermediate- and high-risk patients, to nelarabine or not.
Five-year disease-free survival was 88.2 percent with nelarabine against 82.1 percent without, with fewer central nervous system relapses; Capizzi methotrexate was superior to high-dose methotrexate in this T-cell population, the opposite of B-ALL.
- Five-year disease-free survival 88.2 percent with nelarabine vs 82.1 percent without.
- Overall five-year survival 90.2 percent for the whole T-ALL cohort.
Nelarabine is part of standard therapy for intermediate- and high-risk childhood T-ALL, and Capizzi methotrexate is preferred in T-ALL.
- Neurotoxicity of nelarabine requires monitoring.
- Cranial irradiation was still used for many patients; its omission was tested later.
Similar pages
not linked directly; found by shared links- Key paperAALL0232: dexamethasone and high-dose methotrexate improve outcome in high-risk B-cell acute lymphoblastic leukaemia in children and young adults
Shares High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL), Journal of Clinical Oncology.
- CancerRelapsed and refractory acute lymphoblastic leukaemia in children
Shares Nelarabine, High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL).