A Single Dose of PEG-Asparaginase at the Beginning of Induction Not Only Accelerates MRD Clearance but Also Improves Long-Term Outcome in Children with B-Lineage ALL
Year: 2023
Type: article
Study design: Clinical Trial
Abstract: on day 3 of induction therapy in children with B-lineage ALL. METHODS: Conventional induction therapy consisted of dexamethasone, vincristine, and daunorubicin. MRD data was available in 502 patients who were randomized at the start of induction therapy, standard-risk (SR) patients into three (conventional induction without PEG, induction with additional PEG and with PEG but without daunorubicin) and intermediate-risk (ImR) patients into two groups (with additional PEG and without PEG). RESULTS: The single administration of PEG resulted in a significantly higher proportion of rapid responders, in SR patients even when no anthracyclines were used for induction. In the SR group, the event-free survival of the MFC-MRD fast responders was similar in the PEG- and PEG+ arms (92.0 ± 3.1% vs. 96.2 ± 1.5%, respectively), and the same unfavorable trend was observed for MFC-MRD slow responders (57.5 ± 12.3% vs. 66.7 ± 15.7%, respectively). Results were similar in ImR patients: (94.3 ± 3.2% vs. 95.1 ± 2.4%, for fast responders and 63.3 ± 7.6% vs. 78.1 ± 7.9%, for slow responders in PEG- and PEG+ arms, respectively). However, there is a large difference between the proportion of MFC-MRD slow responders in the PEG- and PEG+ groups (18.3% vs. 5.2% for the SR group and 44.2% vs. 25.0% for the ImR group). CONCLUSIONS: Therefore, early use of PEG-ASP not only leads to an accelerated reduction of blasts, but also to an excellent outcome in a significantly larger proportion of patients in both risk groups.
Source: Cancers
Authors: Alexander Popov, Günter Henze, Julia Roumiantseva, Oleh Bydanov, Mikhail Belevtsev, Tatiana Verzhbitskaya, Liudmila Movchan, Grigory Tsaur, Svetlana Lagoyko, Liudmila Zharikova, Natalia Myakova, Dmitry Litvinov, Olga Khlebnikova, Olga Streneva, Elena Stolyarova, Natalia Ponomareva, Galina Novichkova, Larisa Fechina, Olga Aleinikova, Alexander Karachunskiy
Institutions: Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Charité – Universitätsmedizin Berlin, Belarusian Research Center For Pediatric Oncology and Hematology, Institute of Medical Cell Technologies, Regional Children's Hospital No1, Russian Children's Clinical Hospital
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,892
OpenAlex ID: W4388944792