Acute Lymphoblastic Leukemia in Young Adults Treated with Intensive Pediatric Type Protocol

摘要

Young adults with acute lymphoblastic leukemia do better when treated on “pediatric” protocols. Young adults (18–30 years) with Ph-negative ALL treated between 2000 and 2014 were retrospectively analyzed. Two-hundred and thirty-two patients were included [median age 21 years (18–30); 176 (76%) males; median WBC 16,000/cmm]. Protocols used were: BFM 95 (N = 147, 63%), MCP-841 (N = 51, 22%), GMALL (N = 21, 9%), INCTR (N = 9, 4%) and UKALL (N = 4, 2%). Complete remission was achieved in 194/232 (84%). Twenty patients (9%) died due to toxicity which was higher with BFM versus others (18/147 vs. 2/85; p = 0.031). After a median follow-up of 48 months, median RFS and OS were 35.5 months (25–46), and 25 months (18–31) and actuarial RFS and OS (5-years) were 45% (37–53) and 39% (32–46). BFM protocol improved RFS (51 vs. 35%, p = 0.027) but not OS (43 vs. 33%, p = 0.2). The survival outcomes reported are 15–20% lower than those reported from West. Better supportive care and risk-adapted therapy may improve outcomes.Electronic supplementary materialThe online version of this article (doi:10.1007/s12288-017-0892-y) contains supplementary material, which is available to authorized users.