[Results of treatment of acute lymphoblastic leukemia in children using the BFM 83 protocol in the Czech Republic. Cooperative Group for Childhood Leukemia in the Czech Republic].

Abstract

At the beginning of the eighties the Czech Republic had a chance to cure completely less than 30% of children treated on account of acute lymphoblastic leukaemia (ALL). Introduction of a very intensive protocol ALL-BFM 83 in all leukaemia centres in the Czech Republic in the mid-eighties led to radical improvement of the prognosis of the sick children. In 1985-1990 339 children were treated by therapy differentiated according to the degree of risk. Remission was achieved in 90.5%, by Dec. 31 1991 61% of the children lived in their first complete remission. Based on the above results the 5-year probability of survival was calculated for the whole group as 62%. Children with a standard risk of an adverse course and children where the diagnosis was made at the age of 1-10 years had the most favourable prognosis. The poorest therapeutic results were recorded in children with a high risk of an adverse course and in children under one year at the time of the diagnosis. During the investigation period a relapse of the disease occurred in 25% patients, most frequent was an isolated medullary relapse in 13%; leukaemia of the CNS was diagnosed in 7.5% and 5.5% of the boys suffered from leukaemic infiltration of the testes. The newly introduced nation-wide protocol ALL-BFM 90 gives further hope of an improved prognosis of children with ALL.