{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:50:40Z","timestamp":1780073440093,"version":"3.54.0"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2005,7,8]],"date-time":"2005-07-08T00:00:00Z","timestamp":1120780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2006,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>A previous Pediatric Oncology Group (POG) study showed high incidence of secondary acute myelogenous leukemia (AML) in children treated for T\u2010cell acute lymphoblastic leukemia (T\u2010ALL) or higher\u2010stage lymphoblastic lymphoma. To prevent secondary neoplasms, induce prolonged asparagine depletion, and maintain high event\u2010free survival (EFS) in children with newly diagnosed T\u2010ALL or higher\u2010stage non\u2010Hodgkins lymphoma (NHL), we designed this pilot study to determine feasibility and safety of substituting methotrexate\/mercaptopurine for teniposide\/cytarabine and PEG\u2010asparaginase for native asparaginase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Forty\u2010five patients were entered, 29 with T\u2010ALL and 16 with higher\u2010stage NHL. Forty\u2010two of 45 patients achieved complete remission (CR), and 27 completed the therapy in continuous CR. Treatment consisted of 4\u2010week induction then 6 weeks consolidation and ten 9\u2010week maintenance cycles. Therapy primarily comprised antimetabolites, anthracyclines, alkylating agents, and asparaginase. Expected chemotherapy duration was 100 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two of 45 patients achieved CR, and 27 completed therapy. The most common toxicities were Grade 3 or 4 myelosuppression after cyclophosphamide\/cytarabine and allergic reactions to asparaginase. Two died of sepsis early in maintenance. Five\u2010year EFS was 68.5% (SE 9.1%) for T\u2010ALL and 81.3% (SE 9.8%) for NHL. Five\u2010year EFS was 73.1% (SE 6.8%) for the entire cohort. No patients treated entirely on this study developed secondary neoplasms. One patient taken off study for asparaginase toxicity was treated with multiagent therapy that contained teniposide, and died from secondary myelodysplasia (sMDS)\/AML.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Substituting methotrexate\/mercaptopurine for teniposide\/cytarabine and PEG\u2010asparaginase for native asparaginase in a dose\u2010intensive regimen was feasible in children and young adults with newly diagnosed T\u2010ALL or higher\u2010stage NHL. EFS was not compromised and secondary neoplasms were decreased. \u00a9 2005 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.20429","type":"journal-article","created":{"date-parts":[[2005,7,8]],"date-time":"2005-07-08T20:05:15Z","timestamp":1120853115000},"page":"179-186","source":"Crossref","is-referenced-by-count":20,"title":["Antimetabolite\u2010based therapy in childhood T\u2010cell acute lymphoblastic leukemia: A report of POG study 9296"],"prefix":"10.1002","volume":"46","author":[{"given":"Stuart S.","family":"Winter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark T.","family":"Holdsworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meenakshi","family":"Devidas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis W.","family":"Raisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen","family":"Chauvenet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaddanapudi","family":"Ravindranath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Ducore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Amylon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,12,20]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"152","volume-title":"Malignant T\u2010cell and other non\u2010hodgkin's lymphoma of childhood","author":"Amylon MD","year":"1986"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2401310"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197504172921604"},{"key":"e_1_2_6_5_2","first-page":"735","article-title":"Biology and treatment of childhood t\u2010lineage acute lymphoblastic leukemia","volume":"91","author":"Uckun FM","year":"1998","journal-title":"Blood"},{"key":"e_1_2_6_6_2","first-page":"1680","article-title":"L\u2010asparaginase may potentiate the leukemogenic effect of the epipodophyllotoxins","volume":"9","author":"Pui CH","year":"1995","journal-title":"Leukemia"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.1125"},{"key":"e_1_2_6_8_2","first-page":"401","article-title":"Myelodysplastic syndromes in the adolescent","volume":"10","author":"Winter SS","year":"1999","journal-title":"Adolesc Med"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.6.1039"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2000.01843.x"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198907203210302"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2000.19236"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2400572"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1998.00677.x"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199802193380803"},{"key":"e_1_2_6_16_2","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1182\/blood.V60.5.1159.1159","article-title":"Modified lsa2\u2010l2 treatment in 53 children with e\u2010rosette\u2010positive T\u2010cell leukemia: Results and prognostic factors (a pediatric oncology group study)","volume":"60","author":"Pullen DJ","year":"1982","journal-title":"Blood"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V75.1.166.166"},{"key":"e_1_2_6_18_2","first-page":"541","article-title":"Different patterns of relapse associated with three intensive treatment regimens for pediatric e\u2010rosette positive T\u2010cell leukemia: A pediatric oncology group study","volume":"6","author":"Falletta JM","year":"1992","journal-title":"Leukemia"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200203000-00005"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.6.1285"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.1.246"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-911X(199607)27:1<15::AID-MPO4>3.0.CO;2-X"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1989.7.10.1539"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19930501)71:9<2854::AID-CNCR2820710929>3.0.CO;2-J"},{"key":"e_1_2_6_25_2","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1038\/sj.leu.2401555","article-title":"Significance of commonly used prognostic factors differs for children with T\u2010cell acute lymphoblastic leukemia (all) as compared to those with b\u2010precursor all. 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