See Supplemental Appendix for list of CALLCG members.
Systematic review and meta-analysis of randomized trials of central nervous system directed therapy for childhood acute lymphoblastic leukemia†
Article first published online: 12 JUN 2012
Copyright © 2012 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 60, Issue 2, pages 185–195, February 2013
How to Cite
Richards, S., Pui, C.-H., Gayon, P. and on behalf of the Childhood Acute Lymphoblastic Leukemia Collaborative Group (CALLCG) (2013), Systematic review and meta-analysis of randomized trials of central nervous system directed therapy for childhood acute lymphoblastic leukemia. Pediatr. Blood Cancer, 60: 185–195. doi: 10.1002/pbc.24228
Conflicts of interest: Nothing to declare.
- Issue published online: 14 DEC 2012
- Article first published online: 12 JUN 2012
- Manuscript Accepted: 16 MAY 2012
- Manuscript Received: 10 APR 2012
- childhood leukemia;
- triple intrathecal therapy
Treatment of the central nervous system (CNS) is an essential therapy component for childhood acute lymphoblastic leukemia (ALL). Individual patient data from 47 trials addressing 16 CNS treatment comparisons were analyzed. Event-free survival (EFS) was similar for radiotherapy versus intrathecal (IT), and radiotherapy plus IT versus IV methotrexate (IV MTX) plus IT. Triple intrathecal therapy (TIT) gave similar EFS but poorer survival than intrathecal methotrexate (IT MTX), but additional IV MTX improved both outcomes. One trial resulted in similar EFS and survival with IV MTX plus IT MTX versus TIT alone. Radiotherapy can generally be replaced by IT therapy. TIT should be used with effective systemic therapy such as IV MTX. Pediatr Blood Cancer 2013;60:185–195. © 2012 Wiley Periodicals, Inc.