Details

Autor(en) / Beteiligte

• Stock, Wendy
• Luger, Selina M.
• Advani, Anjali S.
• Yin, Jun
• Harvey, Richard C.
• Mullighan, Charles G.
• Willman, Cheryl L.
• Fulton, Noreen
• Laumann, Kristina M.
• Malnassy, Greg
• Paietta, Elisabeth
• Parker, Edy
• Geyer, Susan
• Mrózek, Krzysztof
• Bloomfield, Clara D.
• Sanford, Ben
• Marcucci, Guido
• Liedtke, Michaela
• Claxton, David F.
• Foster, Matthew C.
• Bogart, Jeffrey A.
• Grecula, John C.
• Appelbaum, Frederick R.
• Erba, Harry
• Litzow, Mark R.
• Tallman, Martin S.
• Stone, Richard M.
• Larson, Richard A.

Titel

A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: results of CALGB 10403

Ist Teil von

• Blood, 2019-04, Vol.133 (14), p.1548-1559

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Retrospective studies have suggested that older adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL) have better survival rates when treated using a pediatric ALL regimen administered by pediatric treatment teams. To address the feasibility and efficacy of using a pediatric treatment regimen for AYA patients with newly diagnosed ALL administered by adult treatment teams, we performed a prospective study, CALGB 10403, with doses and schedule identical to those in the Children's Oncology Group study AALL0232. From 2007 to 2012, 318 patients were enrolled; 295 were eligible and evaluable for response. Median age was 24 years (range, 17-39 years). Use of the pediatric regimen was safe; overall treatment-related mortality was 3%, and there were only 2 postremission deaths. Median event-free survival (EFS) was 78.1 months (95% confidence interval [CI], 41.8 to not reached), more than double the historical control of 30 months (95% CI, 22-38 months); 3-year EFS was 59% (95% CI, 54%-65%). Median overall survival (OS) was not reached. Estimated 3-year OS was 73% (95% CI, 68%-78%). Pretreatment risk factors associated with worse treatment outcomes included obesity and presence of the Philadelphia-like gene expression signature. Use of a pediatric regimen for AYAs with ALL up to age 40 years was feasible and effective, resulting in improved survival rates compared with historical controls. CALGB 10403 can be considered a new treatment standard upon which to build for improving survival for AYAs with ALL. This trial was registered at www.clinicaltrials.gov as #NCT00558519. •Using an intensive pediatric regimen for AYAs with ALL is feasible.•High rates of EFS and OS were seen compared with historical controls. [Display omitted]