Optimizing Pediatric Leukemia Care in Countries With Limited Resources

Mené sur 6 187 patients pédiatriques atteints d'une leucémie lymphoblastique aiguë (âge inférieur à 19 ans), cet essai randomisé évalue l'efficacité, du point de vue de la maladie résiduelle mesurée par cytométrie en flux, de la survie sans événement à 5 ans et de la survie globale, d'une intensification précoce des doses de méthotrexate

Résumé en anglais

In the article accompanying this editorial, Campbell et al13 report the results of the ALL-IC-BFM 2009 study, in which children with high-risk or intermediate-risk ALL from middle-income countries (MICs) were randomly assigned to receive conventional or augmented phase IB and children with intermediate-risk B-cell ALL consolidation with high-dose methotrexate at 2 g/m2 or 5 g/m2, once daily, every 2 weeks, for four doses with flow cytometry being used to assess minimal residual disease for risk stratification purposes, and they conclude that augmented phase IB and consolidation conferred no advantage over conventional therapy. This initiative represents a successful model for conducting phase III randomized studies of ALL treatment in countries with limited resources, and it has generated knowledge relevant to clinical investigators in both high-income countries and MICs.