Efficacy and toxicity of dexamethasone vs methylprednisolone—long-term results in more than 1000 patients from the Russian randomized multicentric trial ALL-MB 2002
Optimal choice of glucocorticoids (GC), like dexamethasone (DEXA) vs (methyl)prednisolone (MePRED) for remission induction in childhood acute lymphoblastic leukemia (ALL) remains controversial. The favorable antileukemic efficacy of DEXA is off-set by its dose-limiting toxicity. Hence, one objective of trial ALL-Moscow/Berlin (MB) 2002 was to evaluate whether an equiactive dose of MePRED leads to superior event-free survival (EFS) rates by reducing mortality, while maintaining the low relapse rates and central nervous system (CNS) protection obtained with DEXA previously. Of 1163 pediatric patients with newly diagnosed B-cell precursor or T-cell ALL, 1064 were randomized to induction with either 6 mg/m^2 DEXA (n=539) or 60mg/m^2 MePRED(n=525).