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Kliman D, Barnett M, Broady R, Forrest D, Gerrie A, Hogge D, Nantel S, Narayanan S, Nevill T, Power M, Sanford D, Song K, Sutherland H, Toze C, Abou Mourad Y. Comparison of a pediatric-inspired treatment protocol versus standard-intensity chemotherapy for young adults with standard-risk BCR-ABL negative acute lymphoblastic leukemia. Leuk Lymphoma 2016; 58:909-915. [PMID: 27561638 DOI: 10.1080/10428194.2016.1222376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We investigated the utility of a pediatric-inspired protocol in adults aged 18-40 years with standard-risk BCR-ABL negative acute lymphoblastic leukemia (ALL). Retrospective outcomes of 25 patients treated with a pediatric protocol between 2008 and 2014 were compared with 22 similarly aged patients treated with an adult protocol between 2003 and 2008. Twenty-five (100%) and 19 (86%) patients achieved complete remission, respectively. At median follow-up of 36.8 months, 3-year event-free survival was increased in patients on the pediatric protocol at 80% versus 45% (p = .019). There was a trend toward improved overall survival at 80% versus 59% (p = .12). Treatment-related toxicity was not increased despite the increased treatment intensity. Patients with BCR and/or ABL copy number variation demonstrated comparatively poorer outcomes in both cohorts. In our experience with this cohort of patients, pediatric-based protocols are safe and effective, justifying their use in younger adults with ALL.
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Affiliation(s)
- David Kliman
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Michael Barnett
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Raewyn Broady
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Donna Forrest
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Alina Gerrie
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Donna Hogge
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Stephen Nantel
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Sujaatha Narayanan
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Thomas Nevill
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Maryse Power
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - David Sanford
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Kevin Song
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Heather Sutherland
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Cynthia Toze
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
| | - Yasser Abou Mourad
- a Leukemia/BMT Program of British Columbia, Division of Hematology , Vancouver General Hospital, University of British Columbia , Vancouver , BC , Canada
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