{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:17:59Z","timestamp":1789697879162,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intensified postinduction therapy improves outcomes for high\u2010risk pediatric patients with acute lymphoblastic leukemia (ALL) in high\u2010income countries. However, benefits are uncertain in middle\u2010income countries where supportive care is often limited. The primary objective was to determine if augmented protocal I phase B (IB) reduced the 5\u2010year cumulative incidence of relapse compared with standard IB among newly diagnosed pediatric patients with intermediate\u2010 and high\u2010risk (IR and HR) ALL in a middle\u2010income country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a randomized, phase III multicenter study conducted in 30 centers from GATLA group in Argentina, as part of International BFM study group ALLIC. We included newly diagnosed pediatric patients with ALL 1\u201318 years of age with IR or HR B\u2010 and T\u2010precursor ALL. Only patients who were in complete remission at end induction were randomized to augmented IB versus standard IB. Augmented IB consisted of cyclophosphamide, cytarabine, 6\u2010mercaptopurine, vincristine, <jats:italic>E. coli<\/jats:italic> <jats:sc>l<\/jats:sc>\u2010asparaginase and intrathecal methotrexate. Standard IB consisted of cyclophosphamide, 6\u2010mercaptopurine, cytarabine, and intrathecal methotrexate. The primary outcome was the cumulative incidence of relapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 1060 patients randomized to standard IB (<jats:italic>n<\/jats:italic>\u00a0=\u00a0527) and augmented IB (<jats:italic>n<\/jats:italic>\u00a0=\u00a0533). The 5\u2010year cumulative incidence of relapse (\u00b1standard error) was not significantly different by group (22.6\u00a0\u00b1\u00a00.2\u00a0vs. 22.3\u00a0\u00b1\u00a00.1%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.97) for standard IB and augmented IB, respectively. Treatment\u2010related mortality (TRM) was 6.5\u00a0\u00b1\u00a00.1 and 7.5\u00a0\u00b1\u00a00.1%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.45, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among newly diagnosed pediatric patients with IR and HR ALL treated in Argentina, postinduction intensification with augmented IB did not improve outcomes compared with standard IB. Standard IB should be used for these patients. Future trials should focus on reducing TRM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31886","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T04:33:13Z","timestamp":1752121993000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Results of a Randomized Augmented Intensification Phase in Acute Lymphoblastic Leukemia in Children in Argentina: GATLA 2010 ALL IC Trial"],"prefix":"10.1002","volume":"72","author":[{"given":"Maria C.","family":"Riccheri","sequence":"first","affiliation":[{"name":"Hospital Nacional Profesor Dr Alejandro Posadas Haedo Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6198-9778","authenticated-orcid":false,"given":"Sergio M.","family":"Gomez","sequence":"additional","affiliation":[{"name":"Hospital Sor Maria Ludovica La Plata Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Deana","sequence":"additional","affiliation":[{"name":"Hospital Nacional Profesor Dr Alejandro Posadas Haedo Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alcira B.","family":"Fynn","sequence":"additional","affiliation":[{"name":"Hospital Sor Maria Ludovica La Plata Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Negri\u2010Aranguren","sequence":"additional","affiliation":[{"name":"Hospital Materno Infantil San Roque Entre Rios Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Arbesu","sequence":"additional","affiliation":[{"name":"Hospital Pediatrico Dr H. Notti Mendoza Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela","family":"Elena","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Pedro Elizalde Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horacio","family":"Caferri","sequence":"additional","affiliation":[{"name":"Hospital Penna Bahia Blanca Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Cedola","sequence":"additional","affiliation":[{"name":"Sanatorio San Lucas Neuquen Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Soria","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Ricardo Gutierrez Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Reichel","sequence":"additional","affiliation":[{"name":"CePSI Hospital de Ninos Santiago del Estero Santiago del Estero Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Makiya","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Hollmann","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Borchichi","sequence":"additional","affiliation":[{"name":"Hospital Pediatrico Barreyro Misiones Posadas Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Ricardo Gutierrez Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Schuttenberg","sequence":"additional","affiliation":[{"name":"Hospital Sor Maria Ludovica La Plata Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Tomassetti","sequence":"additional","affiliation":[{"name":"Hospital Centenario de Santa Fe Rosario Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mae","family":"Arrieta","sequence":"additional","affiliation":[{"name":"Hospital de Rawson de San Juan San Juan Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Dibar","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Sung","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.1636"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11684-020-0759-8"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.01760"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24911"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-02-070342"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70243-8"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1034450"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.20430"},{"issue":"10","key":"e_1_2_7_10_1","first-page":"1783","article-title":"Proposals for the Immunological Classification of Acute Leukemias. 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