Interfant-06: outcome of infants under one year with acute lymphoblastic leukaemia
This international trial of infant leukaemia found no benefit from adding myeloid-style chemotherapy courses, and confirmed that KMT2A-rearranged infants remain a high-risk group with survival under 50 percent, setting the baseline that blinatumomab has since improved.
Overview
International trial of 651 infants with ALL treated on the Interfant backbone, with 240 medium- and high-risk KMT2A-rearranged infants randomised to standard lymphoid-style consolidation or myeloid-style (ADE and MAE) courses; allogeneic transplant was indicated for high-risk patients.
Six-year event-free survival was 46.1 percent overall; there was no difference between consolidation arms (39.3 versus 37.2 percent), and KMT2A-rearranged infants had 36 percent event-free survival against 74 percent for germline KMT2A.
- Six-year event-free survival 46.1 percent overall; 36 percent for KMT2A-rearranged infants.
- No benefit from myeloid-style consolidation (39.3 percent vs 37.2 percent).
Interfant-06 is the backbone and control benchmark for infant ALL; the successor Interfant-21 adds blinatumomab after this trial showed chemotherapy intensification had reached its limit.
- Toxicity-related deaths remained substantial in infants.