Treatment of relapsed childhood acute lymphoblastic leukaemia on UKALL R2 protocol: a limited centre analysis
Anna Cargill and Sharon Love with Anindita Roy, Donna Lancaster, Ian Hann (London), Phil Darbyshire (Birmingham), Anthony Moorman (Southampton), Tim Eden (Manchester), Vaskar Saha (London)
Considerable progress has been made in the treatment of newly diagnosed childhood acute lymphoblastic leukaemia (ALL) over the past two decades. With the use of intensive risk adapted chemotherapeutic protocols, survival rates have improved to over 80%. The challenge now is to successfully treat the 20-30% of children who relapse despite the intensive frontline therapy.
UKALL R2 is the second study in a series of three to establish the most appropriate treatment for children with relapsed ALL using risk adapted protocols. UKALL R1 was the first study in the series and ran from January 1991 to April 1995. The published results recommend BMT for all patients other than those with testicular relapse more than 6 months after completing primary treatment. Although the study aimed to compare autologous BMT versus chemotherapy for those without a sibling donor, inadequate randomisation did not allow such comparisons.
An extension of the R1 trial is the UKALL R2 trial which ran from 1995 to Dec 2002 – this investigates the results of a limited centre analysis of 150 patients treated on the R2 protocol. The main focus was to evaluate the role of matched unrelated BMT for children with relapsed ALL, and also to validate the risk stratification used in the third investigation (UKALL R3) of the series. The analysis of UKALL R2 is complete and the paper is ready to be published.
