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2025-01-17T14:17:50.000Z

AIEOP-BFM ALL 2009 long-term results: Reduced dose daunorubicin for pediatric patients with B-cell ALL

Jan 17, 2025
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Learning objective: After reading this article, learners will be able to cite a new clinical development in acute lymphoblastic leukemia.

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The first randomization in the multicenter AIEOP-BFM ALL 2009 trial (NCT01117441; EudraCT 2007-004270-43) assessed the safety and efficacy of two (EA; n = 1,039) vs four (CA; n = 1,040) doses of daunorubicin during induction in ND pediatric patients aged 1 to <18 years with non-high-risk B-ALL.1 Long-term results from this trial were presented at the 66th ASH Annual Meeting and Exposition by Schrappe.1


Key learnings

EFS was similar between patients in the EA vs CA at both 5 years (92.7% vs 92.3%) and 8 years (90.6% vs 91.1%) (p = 0.83).

OS was also comparable between patients in the EA vs CA; the 5-year OS was 97.3% vs 97.7% and the 8-year OS was 97.2% vs 97.6% (p = 0.69).
The rates of systemic/invasive fungal infections (1.5% vs 0.5%) and sinus venous thrombosis (1.2% vs 0.2%) were higher in the CA vs EA.
These results suggest that reducing daunorubicin from two doses to four doses during induction does not comprise efficacy outcomes and may reduce toxicities in ND pediatric patients with B-ALL.

Abbreviations: ASH, American Society of Hematology; B-ALL, B-cell acute lymphoblastic leukemia; CA, control arm; EA, experimental arm; EFS, event-free survival; ND, newly diagnosed; OS, overall survival.

  1. Schrappe M. A reduced daunorubicin dose during induction is equally effective as standard dose in children with acute lymphoblastic leukemia (ALL) and favorable prognostic features: Long-term results of the phase 3 trial AIEOP-BFM ALL 2009. Oral abstract #309. Presented at: 66th ASH Annual Meeting and Exposition; Dec 7–10, 2024; San Diego, US.

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