AIEOP non-B ALL trials

Modern therapeutic strategies in childhood ALL allow to obtain a 5-year EFS of more than 70%. Multiinstitutional protocols have been started in Italy since early 70s by the Associazione Italiana di Ematologia ed Oncologia Ped iatrica (AIEOP). Organizational level has progressively improved over the y ears and in the last decade results have been comparable to those obtained by all other international cooperative groups. Since 1988 AIEOP introduced the BFM intensive therapeutic strategy and stratification criteria; this st udy yielded a 6-year EFS of 67% and showed that extended intrathecal methot rexate may replace cranial radiotherapy for prevention of CNS relapse in in termediate risk (IR) ALL children treated with BFM-based intensive chemothe rapy. Following this experience, the AIEOPALL 91 study was started and incl uded a randomized clinical trial on the efficacy of protracted high dose L- Asparaginase therapy in Standard Risk and IR patients. Results of these ran domized studies, however, are not yet available. Overall 5-years EFS was 71 % in these patients; this study has shown that cranial radiotherapy may be necessary to obtain optimal results in T-ALL presenting with a high WBC cou nt (greater than or equal to 100,000/cmm) and that polychemotherapy blocks do not improve results in the high risk group. The current AIEOP ALL 95 stu dy has been designed to evaluate, in the context of an international meta-a nalytic prospective randomized study, the role of Vincristine/Dexametasone pulses during maintenance in IR patients. For the future the AIEOP plans to foster and to conduct more and more clinical and research studies in child hood ALL in the frame of international intergroup cooperative projects.