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The Pediatric Forum |

Trial Effect in Newly Diagnosed Pediatric Acute Lymphoblastic Leukemia

Ketan Prasad Kulkarni, MD; Laxman Singh Arya, MD
Arch Pediatr Adolesc Med. 2010;164(9):882-883. doi:10.1001/archpediatrics.2010.141.
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We read with interest the article by Koschmann and colleagues1 describing the lack of trial effect in patients with newly diagnosed acute lymphoblastic leukemia (ALL). However, we have some reservations regarding the conclusions and its potential impact as described. A recent article from Texas confirms that there is a wide variation in the percentage of patients enrolled in cancer clinical trials in different centers owing to variations in ethnicity, geography, health care services, and vulnerable population subgroups.2 It is likely that the percentage of patients accrued on a trial could vary widely among different centers owing to available trials and inclusion criteria that could impact outcome.2 A recent study describes the effect of the center where the cancer was treated on outcome of adolescent cancer patients and underscores the importance of Children's Oncology Group cooperative studies.3

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