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Co-operative study group for childhood acute lymphoblastic leukemia (COALL): long-term follow-up of trials 82, 85, 89 and 92

Leukemia volume 14, pages 2234–2239 (2000)Cite this article

Abstract

The German Co-operative Study Group COALL for treatment of acute lymphoblastic leukemia (ALL) in childhood started the first trial in 1980. This report gives an overview of the long-term results of the four consecutive studies COALL-82, COALL-85, COALL-89 and COALL-92. Besides improvement in long-term survival major objectives were reduction of treatment-related toxicity by transferring asparaginase (ASP) from induction therapy to intensive phase and omitting CNS irradiation by stepwise increase of the initial white blood count (WBC) up to 50 × 109/l (exception T-ALL) as criterion for irradiation. In study COALL-85 in high risk patients slow vs rapid rotational treatment was randomized. In study COALL-92 initial response to daunorubicin (DNR) as a 1-h vs 24-h infusion and its prognostic value was investigated. furthermore, 6-mercaptopurine (6-mp) and 6-thioguanine (6-tg) were randomized in maintenance treatment. in total, 1191 eligible patients were enrolled. induction treatment without asp has been shown to be as effective and less hazardous than the former four-drug induction. cns control could be obtained in most without cranial irradiation (cns relapse-free survival >95%). The leukemic cell kill with a 24-h DNR infusion was equivalent to that of a 1-h infusion. DNR response was of less prognostic significance than prednisone response. The rapid rotation regimen failed to improve outcome as well as 6-TG in maintenance treatment. However, intensification of systemic treatment resulted in an increase in overall event-free survival (EFS) to approximately 80% which is comparable to other groups.

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  1. Department of Hematology and Oncology, Children's University Hospital, Hamburg, Germany

    DO Harms & GE Janka-Schaub

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Harms, D., Janka-Schaub, G. & on behalf of the COALL Study Group. Co-operative study group for childhood acute lymphoblastic leukemia (COALL): long-term follow-up of trials 82, 85, 89 and 92. Leukemia 14, 2234–2239 (2000). https://doi.org/10.1038/sj.leu.2401974

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