Evidence map›Paper›PMID 22409379›Full record

Trial reportBritish journal of haematology2012

Outcomes in older adults with acute lymphoblastic leukaemia (ALL): results from the international MRC UKALL XII/ECOG2993 trial.

Jonathan I Sive, Georgina Buck, Adele Fielding, Hillard M Lazarus, Mark R Litzow, Selina Luger, David I Marks, Andrew McMillan, Anthony V Moorman, Susan M Richards and 3 more

Registry-linked trialOpen access · bronzeAbstract readClinical Trial
In one paragraph

Trial report in British journal of haematology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00002514 (Phase III Randomized Trial of Autologous and Allogeneic Stem Cell Transplantation Versus Intensive Conventional Chemotherapy in Acute Lymphoblastic Leukemia in First Remission), which is not on this map. Cited by 93 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 1 pooled it
8.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00002514 phase3completednot on this map

Phase III Randomized Trial of Autologous and Allogeneic Stem Cell Transplantation Versus Intensive Conventional Chemotherapy in Acute Lymphoblastic Leukemia in First Remission

TypeinterventionalSponsorEastern Cooperative Oncology GroupRan1993Enrolled1,929ConditionsLeukemiaArmssargramostim, asparaginase, cyclophosphamide, cytarabine, daunorubicin hydrochloride
3 · Its place in the literature

Who cites it

93 citing papers in PubMed, 1 synthesis or guideline pooled it, 196 citations in OpenAlex.

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33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 10 institutions in 3 countries.

Jonathan I SiveDepartment of Haematology, University College London Hospital, London. jonathansive@hotmail.com
Georgina Buck
Adele Fielding
Hillard M Lazarus
Mark R Litzow
Selina Luger
David I Marks
Andrew McMillan
Anthony V Moorman
Susan M Richards
Jacob M Rowe
Martin S Tallman
Anthony H Goldstone
University College London · GBMayo Clinic · USMemorial Sloan Kettering Cancer Center · USNewcastle University · GBNottingham City Hospital · GBRambam Health Care Campus · ILThe Royal Free Hospital · GBUniversity Hospitals Bristol NHS Foundation Trust · GBUniversity Hospitals Case Medical Center · USUniversity of Pennsylvania · US

Funding

ECOG Specimen BankingU24CA114737 · NCI · FRONTIER SCI &TECHNOLOGY RSCH FDN, INC · PI COMIS, ROBERT L · 2005 to 2014
$9.3M
ECOG Clinical TrialsU10CA017145 · NCI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI BENSON, AL B · 1985 to 2013
$6.1M
ONCOLOGYU10CA015488 · NCI · UNIVERSITY OF PENNSYLVANIA · PI LUGER, SELINA M · 1985 to 2013
$5.6M
ONCOLOGYU10CA014548 · NCI · CASE WESTERN RESERVE UNIVERSITY · PI AVERBOOK, BRUCE JEFFREY · 1985 to 2013
$5.5M
ONCOLOGYU10CA013650 · NCI · MAYO CLINIC ROCHESTER · PI HABERMANN, THOMAS MATTHEW · 1985 to 2013
$3.1M
Medical Research Council MC_U137686856NCI NIH HHS U10 CA013650NCI NIH HHS U10 CA014548NCI NIH HHS U10 CA015488NCI NIH HHS U10 CA017145NCI NIH HHS U24 CA114737
6 · The paper itself

Abstract

Although the incidence rate of acute lymphoblastic leukaemia (ALL) is slightly higher in older than in younger adults, response rates to induction chemotherapy and survival rates are poorer. The contribution of disease-related versus treatment-related factors remains unclear. We analysed 100 older patients (aged 55-65 years) treated on the UKALLXII/ECOG2993 trial compared with 1814 younger patients (aged 14-54 years). Baseline characteristics, induction chemotherapy course, infections, drug reductions and survival outcomes were compared. There were more Philadelphia-positive (Ph+) patients in the older group (28% vs. 17%, P = 0·02), and a trend towards higher combined cytogenetic risk score (46% vs. 35%, P = 0·07). The complete remission rate in older patients was worse (73% vs. 93%, P < 0·0001) as was 5-year overall survival (21% vs. 41%, P < 0·0001) and event-free survival (EFS) (19% vs. 37%, P < 0·0001). Older patients had more infections during induction (81% vs. 70%, P = 0·05), and drug reductions (46% vs. 28%, P = 0·0009). Among older patients, Ph+ and cytogenetic risk category as well as infection during induction predicted for worse EFS. Poorer outcomes in these patients are partly due to cytogenetic risk, but there is significant morbidity and mortality during induction chemotherapy with frequent delays and drug reductions. New approaches, including better risk stratification and use of targeted therapies, could improve treatment for these patients.

Indexed as

AdolescentAdultAgedAge FactorsFemaleHumansInduction ChemotherapyInfectionsMaleMiddle AgedPrecursor Cell Lymphoblastic Leukemia-LymphomaPrognosisSurvival AnalysisTreatment OutcomeYoung Adult

Identifiers

PMID22409379
PMCPMC4188419
OpenAlexW2008009748

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.