AUTHOR=Zhuang Yong , Wu Kefei , Zhu Xiaofan , Cai Jiaoyang , Hu Shaoyan , Gao Ju , Jiang Hua , Zhai Xiaowen , Tian Xin , Fang Yongjun , Jin Runming , Hu Qun , Jiang Hui , Wang Ningling , Sun Lirong , Leung Wing Kwan , Yang Minghua , Pan Kaili , Wu Xuedong , Liang Changda , Shen Shuhong , Yu Jie , Ju Xiuli 

TITLE=Reduced Dose Intensity of Daunorubicin During Remission Induction for Low-Risk Patients With Acute Lymphoblastic Leukemia: A Retrospective Cohort Study of the Chinese Children’s Cancer Group

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.911567

DOI=10.3389/fonc.2022.911567

ISSN=2234-943X

ABSTRACT=<p>It is urgently necessary to reduce the adverse effects of chemotherapy while maintaining their cure high rates for children with acute lymphoblastic leukemia (ALL). The present study aimed to determine whether the dose intensity of daunorubicin during the remission-induction phase could be reduced for low-risk patients with ALL. A total of 2396 eligible patients, who participated in CCCG-ALL-2015 study and were provisionally assigned to the low-risk group, were included and divided into single-dose group and double-dose group according to the dosage of daunorubicin during the remission-induction phase. For patients with <italic>ETV6-RUNX1</italic> positive ALL or hyperdiploidy ALL, there were no significant differences in outcomes between the two groups. For other patients, the 5-year event-free survival rate was significantly better and the 5-year cumulative risk of any relapse was significantly lower in the double-dose group compared with the single-dose group. Both the 5-year overall survival rate and the risk of early deaths were not significantly different between the two groups. Our results suggested that only B-lineage ALL patients with <italic>ETV6-RUNX1</italic> positivity or hyperdiploidy who achieved an early negative minimal residual disease status were suitable candidates for dosage reduction of daunorubicin during the remission-induction phase.</p><sec><title>Clinical Trial Registration</title><p><uri xlink:href="http://www.chictr.org.cn/showproj.aspx?proj=10115" xmlns:xlink="http://www.w3.org/1999/xlink">http://www.chictr.org.cn/showproj.aspx?proj=10115</uri>, identifier ChiCTR-IPR-14005706.</p></sec>