{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:34:04Z","timestamp":1791290044196,"version":"4.3.0"},"reference-count":44,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"13","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2021,5,1]]},"abstract":"<jats:sec><jats:title>Purpose:<\/jats:title><jats:p> AALL0932 evaluated two randomized maintenance interventions to optimize disease-free survival (DFS) while reducing the burden of therapy in children with newly diagnosed NCI standard-risk (SR) B-acute lymphoblastic leukemia (B-ALL). <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> AALL0932 enrolled 9,229 patients with B-ALL; 2,364 average-risk (AR) patients were randomly assigned (2 \u00d7 2 factorial design) at the start of maintenance therapy to vincristine\/dexamethasone pulses every 4 (VCR\/DEX4) or every 12 (VCR\/DEX12) weeks, and a starting dose of weekly oral methotrexate of 20 mg\/m<jats:sup>2<\/jats:sup> (MTX20) or 40 mg\/m<jats:sup>2<\/jats:sup> (MTX40). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Five-year event-free survival and overall survival (OS) from enrollment (with 95% CIs), for all eligible and evaluable SR B-ALL patients (n = 9,226), were 92.0% (91.1% and 92.8%) and 96.8% (96.2% and 97.3%), respectively. The 5-year DFS and OS from the start of maintenance for randomly assigned AR patients were 94.6% (93.3% and 95.9%) and 98.5% (97.7% and 99.2%), respectively. The 5-year DFS and OS for patients randomly assigned to receive VCR\/DEX4 (n = 1,186) versus VCR\/DEX12 (n = 1,178) were 94.1% (92.2% and 96.0%) and 98.3% (97.2% and 99.4%) v 95.1% (93.3% and 96.9%) and 98.6% (97.7% and 99.6%), respectively ( P = .86 and .69). The 5-year DFS and OS for AR patients randomly assigned to receive MTX20 versus MTX40 were 95.1% (93.3% and 96.8%) and 98.8% (97.9% and 99.7%) v 94.2% (92.2% and 96.1%) and 98.1% (97.0% and 99.2%), respectively ( P = .92 and .89). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> The 0NCI-SR AR B-ALL who received VCR\/DEX12 had outstanding outcomes despite receiving one third of the vincristine\/dexamethasone pulses previously used as standard of care on Children's Oncology Group (COG) trials. The higher starting dose of MTX of 40 mg\/m<jats:sup>2<\/jats:sup>\/week did not improve outcomes when compared with 20 mg\/m<jats:sup>2<\/jats:sup>\/week. The decreased frequency of vincristine\/dexamethasone pulses has been incorporated into frontline COG B-ALL trials to decrease the burden of therapy for patients and their families. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.20.00494","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T21:13:29Z","timestamp":1610054009000},"page":"1437-1447","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":96,"title":["Excellent Outcomes With Reduced Frequency of Vincristine and Dexamethasone Pulses in Standard-Risk B-Lymphoblastic Leukemia: Results From Children's Oncology Group AALL0932"],"prefix":"10.1200","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5673-0737","authenticated-orcid":false,"given":"Anne L.","family":"Angiolillo","sequence":"first","affiliation":[{"name":"Children's National Medical Center, Washington, DC"},{"name":"George Washington University School of Medicine and Health 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