Evidence map›Paper›PMID 30689137›Full record

ArticleInternational journal of hematology2019

Discontinuation of L-asparaginase and poor response to prednisolone are associated with poor outcome of ETV6-RUNX1-positive pediatric B-cell precursor acute lymphoblastic leukemia.

Ikuya Usami, Toshihiko Imamura, Yoshihiro Takahashi, So-Ichi Suenobu, Daiichiro Hasegawa, Yoshiko Hashii, Takao Deguchi, Tsukasa Hori, Akira Shimada, Koji Kato and 9 more

Abstract read
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In one paragraph

Article in International journal of hematology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Impact of Age on Pharmacogenomics and Treatment Outcomes of B-Cell Acute Lymphoblastic Leukemia.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
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  11. Favorable Trisomies andJournal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021
    Article
  12. Review
  13. Article
  14. Article
  15. Impact of Asparaginase Discontinuation on Outcome in Childhood Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020
    Article
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

19 authors.

Ikuya UsamiDepartment of Pediatric Hematology and Oncology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
Toshihiko ImamuraClinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan. imamura@koto.kpu-m.ac.jp.ORCID http://orcid.org/0000-0002-5727-4470
Yoshihiro TakahashiDepartment of Pediatrics, Aomori Prefectural Central Hospital, Aomori, Japan.
So-Ichi SuenobuDivision of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University, Oita, Japan.
Daiichiro HasegawaDepartment of Hematology/Oncology, Hyogo Prefectural Children's Hospital, Kobe, Japan.
Yoshiko HashiiDepartment of Pediatrics, Osaka University, Osaka, Japan.
Takao DeguchiDepartment of Pediatrics, Mie University, Tsu, Japan.
Tsukasa HoriDepartment of Pediatrics, Sapporo Medical University of Medicine, Hokkaido, Japan.
Akira ShimadaDepartment of Pediatrics, Okayama University, Okayama, Japan.
Koji KatoDepartment of Hematology Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
Eturou ItoDepartment of Pediatrics, Hirosaki University, Hirosaki, Japan.
Akiko Moriya-SaitoClinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Hirohide KawasakiDepartment of Pediatrics, Kansai Medical University, Hirakata, Japan.
Hiroki HoriDepartment of Pediatrics, Mie University, Tsu, Japan.
Keiko Yumura-YagiYumura Clinic, Osaka, Japan.
Junichi HaraDepartment of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan.
Atsushi SatoDepartment of Hematology/Oncology, Miyagi Children's Hospital, Sendai, Japan.
Keizo HoribeClinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Japan Association of Childhood Leukemia Study Group (JACLS)

Funding

Ministry of Health, Labour and Welfare H14-Koka (Gan)-031Ministry of Health, Labour and Welfare H15-Koka (Gan)-024Ministry of Health, Labour and Welfare H16-GanRinsho-004Ministry of Health, Labour and Welfare H17-GanRinsho-004
6 · The paper itself

Abstract

ETV6-RUNX1-positive B precursor acute lymphoblastic leukemia (B-ALL) is a common subtype of pediatric B-ALL that has shown excellent outcomes in contemporary clinical trials for pediatric B-ALL. Examinations of the possibility of reducing therapeutic intensity may thus be explored. This prospective study examined outcomes in 205 pediatric patients with ETV6-RUNX1-positive B-ALL uniformly treated following the Japan Association of Childhood Leukemia Study Group (JACLS) ALL-02 protocol. The JACLS ALL-02 protocol does not employ minimal residual disease detected by polymerase chain reaction (PCR-MRD)-based risk stratification; however, 4-year event-free survival (EFS) and overall survival (OS) were 94.4 ± 1.6 and 97.5 ± 1.1%, respectively. In particular, 92 of 205 (44.9%) patients were successfully treated with a less intensive regimen involving only two cycles of high dose methotrexate and one course of re-induction therapy comprising vincristine, L-asparaginase (L-asp), pirarubicin, and prednisolone. Multivariate analysis revealed that discontinuation of L-asp and poor response to prednisolone was, respectively, associated with poor EFS (HR 6.3; 95% CI 1.3-27.0) and OS (HR 17.5; 95% CI 2.3-130), suggesting that the majority of ETV6-RUNX1-positive B-ALL cases may be cured by a less-intensive chemotherapy regimen if the risk stratification system including PCR-MRD monitoring and insufficient use of L-asp is avoided.

Indexed as

AsparaginaseChildChild, PreschoolCore Binding Factor Alpha 2 SubunitDisease-Free SurvivalETS Translocation Variant 6 ProteinFemaleFollow-Up StudiesHumansInfantMaleOncogene Proteins, FusionPrecursor B-Cell Lymphoblastic Leukemia-LymphomaPrednisoloneRisk AssessmentSurvival RateAsparaginaseCore Binding Factor Alpha 2 SubunitETS Translocation Variant 6 ProteinOncogene Proteins, FusionPrednisoloneTEL-AML1 fusion proteinETV6-RUNX1L-asparaginasePediatric acute lymphoblastic leukemiaPoor prednisolone response

Identifiers

PMID30689137

What OpenQuestion holds

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Registered trials

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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.