Improved Outcome of a Pediatric-Inspired Protocol for High-Risk Adolescent and Young Adult Acute Lymphoblastic Leukemia Patients Using Peg-Asparaginase and Escalating Dose of Methotrexate: Tolerability and Outcome

摘要

Treatment of acute lymphoblastic leukemia (ALL) in adolescent and young adult (AYA) patients using traditional adult chemotherapy protocols give low overall survival (OS) rates. The purpose of this prospective study was to assess efficacy and tolerability of treatment of AYA patients using a pediatric-inspired protocol modified from the Children's Cancer Group 1900 protocol for newly diagnosed high-risk Philadelphia chromosome-negative ALL patients. Forty patients with a median age of 18 years (range, 14-34 years) were enrolled in the study. Treatment was effective with a complete remission rate after induction of 93% and was well tolerated; after a 5-year follow-up, improvement in OS and disease-free survival compared with historical data using adult protocols in this population was shown.