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Outcomes of adult acute lymphoblastic leukemia in the era of pediatric-inspired regimens: a single-center experience.

Abstract
Recent data on acute lymphoblastic leukemia (ALL) treatment with multi-agent chemotherapy showed excellent response in pediatric patients in terms of long-term survival; however, the clinical needs for adult patients are still unmet. Adolescent and young adults' (AYA) ALL could benefit from a pediatric-inspired regimen with a higher rate of long-term remission. This retrospective study sought to investigate the efficacy of treatment of adult ALL in a single center over the past decade. We analyzed 107 ALL patients with a median age of 26 years (range 15-63 years). Of these, 67.3% received adult regimen and 32.7% received pediatric-inspired regimen. The median follow-up time was 11.6 months (range 1-120). Complete remission (CR) was similarly achieved in over 80% in both schemes. Relapse and refractory rates were higher in the adult group (75%) than in the pediatric (45.7%) group. Two-year disease-free survival in the pediatric group was significantly superior to the adult group (47.1% vs 24.7%, hazard ratio [HR], 1.73, 95% CI 1.22-3.03). Two-year overall survival was higher in pediatric group as compared to adult group (50.8% versus 31.2%, HR 1.52, 95% CI 0.83-2.78). Thus, these findings show that the pediatric-inspired regimen should be considered for the treatment of adult ALL.
AuthorsAdisak Tantiworawit, Thanawat Rattanathammethee, Chatree Chai-Adisaksopha, Ekarat Rattarittamrong, Lalita Norasetthada
JournalInternational journal of hematology (Int J Hematol) Vol. 110 Issue 3 Pg. 295-305 (Sep 2019) ISSN: 1865-3774 [Electronic] Japan
PMID31161483 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Vincristine
  • Dexamethasone
  • Doxorubicin
  • Cyclophosphamide
Topics
  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
  • Cyclophosphamide (administration & dosage)
  • Dexamethasone (administration & dosage)
  • Disease-Free Survival
  • Doxorubicin (administration & dosage)
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy, mortality)
  • Remission Induction
  • Retrospective Studies
  • Survival Rate
  • Vincristine (administration & dosage)

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