By recording all children and adolescents with an ALL recurrence as completely as possible in a register, epidemiological statements can be made about the incidence, course and prognosis of children with ALL recurrence. This group contributes more than any other to the mortality of children with malignant diseases. Patients can be systematically followed up, late effects recorded and correlated with previous therapies and clinical factors. Corresponding risks can be taken into account in future therapy strategies. As a competence centre for relapsed/refractory ALL, the study centre can advise participating centres on specific questions regarding individual therapy strategies as well as radiation and transplantation indications. Patients with relapsed and/or refractory ALL can be counselled regarding treatment in an open AMG study and assigned accordingly.
The treatment instructions enclosed with this protocol do not represent recommendations for a generally recognised treatment in this specific form and combination, but are rather guidelines for treatment.
The risk groups S1 to S4 are categorised according to the definition of the ALL-REZ BFM 2002 study. The only change to this classification is the categorisation of very early isolated extramedullary recurrences in the S4 group. Due to the good results of the ALL-REZ BFM 2002 study, treatment according to the ALL-REZ BFM 2002 protocol is still recommended for children and adolescents with first ALL recurrence until the start of the new international ALL recurrence study. Consolidation is carried out with protocol II-Ida. In the event of a subsequent relapse, consultation with the study centre is recommended.
