The Outcome of Childhood High-Risk Acute Lymphoblastic Leukemia: 10 Years of Experience with the ALL-BFM 95 Protocol in Chinese Single Centre

Objectives: To evaluate the effectiveness and the practicability of Acute Lymphoblastic Leukemia Berlin-Frankfurt-Münster 95 (ALL-BFM 95) protocol in treating childhood high-risk (HR) acute lymphoblastic leukemia (ALL) in Chinese single centre.

Methods: A retrospective analysis of 47 children with novo high risk ALL from July 2003 and August 2013 was performed. These children treated by the ALL-BFM 95 protocol. Median follow-up time was 39 months (16~127months). Survival was evaluated by Kaplan Meier analysis and Log-Rank test.

Results:Relapse-related death occurred in 12 of 47 patients (25.5%), and 5 of 47 patients (10.6%) were treatment-related mortality. Five-year probability of event-free-survival (pEFS) were found to be 62.4%. High risk ALL children only with prednisone poor response(PPR) has good outcome who’s Five-year probability of event-free-survival (pEFS) could reach to 80%. Children with hematopoietic stem cell transplantation (HSCT) after chemotherapy achieved significantly better pEFS than only chemotherapy (77.3% vs 51.6%，p=0.035). pEFS for B-cell precursor and T-cell ALL was 64.5% and 57.1%, respectively（P=0.633）.

Conclusions: ALL-BFM 95 protocol can also improve the outcome of childhood high risk ALL in China. The leading causes of death were relapse. HSCT treatment had better outcome than only chemotherapy in high risk ALL children in CR1 phase.