Dexamethasone versus Prednisone in Childhood Acute Lymphoblastic Leukemia Treatment: Results of the Indonesian Randomized Trial
| العنوان: | Dexamethasone versus Prednisone in Childhood Acute Lymphoblastic Leukemia Treatment: Results of the Indonesian Randomized Trial |
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| المؤلفون: | Sutaryo, Anjo J.P. Veerman, Pudjo Hagung Widjajanto, Eddy Supriyadi, Peter M. vdVen, Ignatius Purwanto, Jacqueline Cloos |
| المصدر: | Journal of Cancer Therapy. :735-750 |
| بيانات النشر: | Scientific Research Publishing, Inc., 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | medicine.medical_specialty, business.industry, Mortality rate, Significant difference, Treatment results, Gastroenterology, Surgery, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Induction Death, Prednisone, law, 030220 oncology & carcinogenesis, Internal medicine, medicine, business, Childhood Acute Lymphoblastic Leukemia, Dexamethasone, 030215 immunology, medicine.drug |
| الوصف: | Background: Randomized trials report that, compared to prednisone, dexamethasone has reduced CNS relapse and improved event-free survival (EFS), despite a trend toward a higher risk for induction death. Because toxic death is a specific problem in the Indonesian setting, this study compares the outcome of dexamethasone versus prednisone. Methods: In the period 2006 - 2011, 196 patients with childhood acute lymphoblastic leukemia (ALL) treated on the Indonesia-ALL-2006 protocol [first standard risk (SR) and later high risk (HR) patients] were randomized to receive dexamethasone or prednisone as steroid. Patients in the dexamethasone arm (n = 102: 68 SR, 34 HR) received dexamethasone 4 mg/m2/day (SR) or 6 mg/m2/day (HR), while the prednisone arm (n = 94: 66 SR, 28 HR) received prednisone 40 mg/m2/day (SR and HR). Results: Patients in the dexamethasone arm showed no significant difference compared to the prednisone arm in abandonment rate (24.5% vs. 25.5%, P = 0.91), death rate (17.7% vs. 14.9%, P = 0.54), or leukemic events (13.7 vs. 11.7%, P = 0.59). After stratification for risk group, a trend towards a higher death rate was found in the dexamethasone arm of SR patients (16.2 vs. 6.1%, P = 0.06). The 3-year survival for EFS in SR and HR patients for dexamethasone versus prednisone was 31.5% ± 6.6% vs. 41.5% ± 5.9% (P = 0.51), for leukemia-free survival (LFS) it was 63.7% ± 9.3% vs. 74.5% ± 7.6% (P = 0.47), and for overall survival (OS) it was 49.5% ± 7.7% vs. 69.3% ± 6.1% (P = 0.09). Conclusions: In our setting, a trend toward higher induction deaths was observed in the dexamethasone arm of SR patients and the 3-year EFS; LFS and OS rates were lower in the dexamethasone group; however, these differences were not significant. |
| تدمد: | 2151-1942 2151-1934 |
| DOI: | 10.4236/jct.2017.88064 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::f103d06e55a004a396fd9d367cc83c45 https://doi.org/10.4236/jct.2017.88064 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi...........f103d06e55a004a396fd9d367cc83c45 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21511942 21511934 |
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| DOI: | 10.4236/jct.2017.88064 |