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Adding the T-cell-specific drug nelarabine to intensive chemotherapy improved disease-free survival in childhood T-cell acute lymphoblastic leukaemia and cut central nervous system relapses, in the largest T-ALL trial ever run.
Phase 3 trial of 1,895 patients with T-ALL of whom 1,562 were randomised in a factorial design to Capizzi or high-dose methotrexate and, for intermediate- and high-risk patients, to nelarabine or not.
Five-year disease-free survival was 88.2 percent with nelarabine against 82.1 percent without, with fewer central nervous system relapses; Capizzi methotrexate was superior to high-dose methotrexate in this T-cell population, the opposite of B-ALL.
Nelarabine is part of standard therapy for intermediate- and high-risk childhood T-ALL, and Capizzi methotrexate is preferred in T-ALL.
Shares Kimberly P. Dunsmore, High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL).
Shares High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL), Journal of Clinical Oncology.
Shares High-risk acute lymphoblastic leukaemia in children (high-risk B-ALL and T-ALL), Journal of Clinical Oncology.