COG AALL0434
AALL0434 was the largest trial ever run in childhood T-cell leukaemia; it showed that adding the drug nelarabine to standard chemotherapy cut relapses, and that most children could be cured without radiation to the brain.
Overview
The Children's Oncology Group trial AALL0434 enrolled 1895 patients aged 1 to 30 with newly diagnosed T-cell acute lymphoblastic leukaemia or T-lymphoblastic lymphoma. Intermediate- and high-risk patients were randomised in a two-by-two design to augmented Berlin-Frankfurt-Munster chemotherapy with or without six courses of nelarabine, and to Capizzi escalating-dose methotrexate with pegaspargase or to high-dose methotrexate.
Nelarabine improved disease-free survival in T-cell leukaemia, with fewer central nervous system relapses, and the Capizzi methotrexate arm outperformed high-dose methotrexate. Cranial irradiation was omitted for all but the highest-risk group without excess central nervous system relapse. Overall survival across the trial was the best yet reported for T-cell leukaemia, and nelarabine became part of front-line therapy for higher-risk disease.
Similar pages
not linked directly; found by shared links- TrialALCANZA
Shares Methotrexate and the tag subtype-trials.
- 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), Methotrexate.
- TrialStudy of Efficacy and Safety of Tisagenlecleucel in HR B-ALL EOC MRD Positive Patients
Shares High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL), Acute lymphoblastic leukaemia.
- TreatmentMercaptopurine
Shares High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL), Methotrexate, Acute lymphoblastic leukaemia.
- TreatmentAminopterin
- TargetDNA polymerase alpha (POLA1)
Shares Nelarabine, Acute lymphoblastic leukaemia.
- PersonRobert Sandler
- PersonDonald Pinkel