ST JUDE-VIVA FORUM: 5-YEAR RESULT OF CCCG-ALL 2015

To determine whether dasatinib given at 80 mg/m² is more effective than imatinib at 300 mg/m² to improve event-free survival of children with Philadelphia chromosome-positive ALL, in the context of intensive chemotherapy without prophylactic cranial irradiation.

We analyzed the data in our recently completed China Children’s Cancer Group ALL-2015 protocol (CCCG-ALL-2015) which totally omitted prophylactic cranial irradiation and included all acute lymphoblastic leukemia (ALL) patients without exclusion any high-risk subgroups. The 5-year event-free survival was 80.3% for 7640 consecutive patients treated on CCCG-ALL-2015 protocol between 2015 and 2019, and overall survival 91.1%. The cumulative risk of isolated CNS relapse was 1.9%, and any CNS relapse 2.7%. The isolated CNS relapse rate was significantly lower in patients with B-ALL than in those with T-ALL. Independent risk factors for isolated CNS relapse included male sex, the presence of BCR–ABL1 fusion in B-ALL, and presenting leukocyte count ≥50×10⁹/L in T-ALL. Significantly lower isolated CNS relapse was associated with the use of total intravenous anesthesia during intrathecal therapy and flow cytometry examination of diagnostic cerebrospinal fluid among patients with B-ALL.