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Children whose leukaemia had come back were far more likely to survive without further relapse if their first block of treatment used mitoxantrone instead of idarubicin, an unexpected finding that changed the standard reinduction treatment.
Open-label randomised trial in 22 centres in the United Kingdom and Ireland and nine in Australia and New Zealand: 216 of 239 registered children aged 1 to 18 with first relapse of acute lymphoblastic leukaemia were randomised to idarubicin or mitoxantrone during induction, with later chemotherapy or transplant decided by risk group and measurable residual disease.
Three-year progression-free survival was 64.6 percent with mitoxantrone against 35.9 percent with idarubicin (p 0.0004), and three-year overall survival 69.0 against 45.2 percent (p 0.004). The difference came from fewer disease events rather than fewer treatment-related deaths.
Mitoxantrone-based reinduction became the reference treatment for relapsed childhood ALL and the control arm of later international relapse trials.
Shares Mitoxantrone, Relapsed and refractory acute lymphoblastic leukaemia in children, Acute lymphoblastic leukaemia.
Shares Idarubicin, Mitoxantrone.
Shares Idarubicin, Mitoxantrone.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Acute lymphoblastic leukaemia.
Shares Relapsed and refractory acute lymphoblastic leukaemia in children, Acute lymphoblastic leukaemia.