Analysis of 20-Year Follow-up Study of LVP Regimen for Adult Acute Lymphoblastic Leukemia

2001 ◽  
Vol 74 (2) ◽  
pp. 157-164 ◽  
Author(s):  
Yoshihiro Hatta ◽  
Jin Takeuchi ◽  
Toshiteru Ohshima ◽  
Akira Horikoshi ◽  
Yoshikazu Iizuka ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Follow Up Study ◽  
Adult Acute Lymphoblastic Leukemia

scholarly journals Treatment of adult acute lymphoblastic leukemia with intensive cyclical chemotherapy: a follow-up report

Blood ◽  
1991 ◽  
Vol 78 (11) ◽  
pp. 2814-2822 ◽  
Author(s):  
CA Linker ◽  
LJ Levitt ◽  
M O'Donnell ◽  
SJ Forman ◽  
CA Ries
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Disease Free Survival ◽  
Remission Induction ◽  
Cell Phenotype ◽  
Free Survival ◽  
Prognostic Features ◽  
Adult Acute Lymphoblastic Leukemia ◽  
Disease Free

Abstract We treated 109 patients with adult acute lymphoblastic leukemia (ALL) diagnosed by histochemical and immunologic techniques. Patients were excluded only for age greater than 50 years and Burkitt's leukemia. Treatment included a four-drug remission induction phase followed by alternating cycles of noncrossresistant chemotherapy and prolonged oral maintenance therapy. Eighty-eight percent of patients entered complete remission. With a median follow-up of 77 months (range, 48 to 111 months), 42% +/- 6% (SEM) of patients achieving remission are projected to remain disease-free at 5 years, and disease-free survival for all patients entered on study is 35% +/- 5%. Failure to achieve remission within the first 4 weeks of therapy and the presence of the Philadelphia chromosome are associated with a 100% risk of relapse. Remission patients with neither of these adverse features have a 48% +/- 6% probability of remaining in continuous remission for 5 years. Patients with T-cell phenotype have a favorable prognosis with 59% +/- 13% of patients achieving remission remaining disease-free compared with 31% +/- 7% of CALLA-positive patients. Intensive chemotherapy may produce prolonged disease-free survival in a sizable fraction of adults with ALL. Improved therapy is needed, especially for patients with adverse prognostic features.

scholarly journals ACUTE LYMPHOBLASTIC LEUKEMIA EXPERIENCE: EPIDEMIOLOGY AND OUTCOME OF TWO DIFFERENT REGIMENS

2013 ◽  
Vol 5 (1) ◽  
pp. e2013024 ◽  
Author(s):  
Salah Abbasi ◽  
Faten Maleha ◽  
Muhannad Shobaki
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Medical Records ◽  
Residual Disease ◽  
Lymphoblastic Leukemia ◽  
Complete Response ◽  
Cancer Center ◽  
Poor Prognostic Factor ◽  
Minimal Residual Disease Monitoring ◽  
Adult Acute Lymphoblastic Leukemia

Objectives. Accurate data about adult acute lymphoblastic leukemia (ALL) are lacking. We aim to assess demographics, prognostic factors, and outcome of ALL therapy at King Hussein Cancer Center (KHCC) in Jordan, and to compare the efficacy of two protocols.Methods. We reviewed medical records of adults diagnosed and treated for ALL at KHCC from January, 2006 to December, 2010.Results. Over a 5-year period, 108 patients with ALL were treated (66 with the Hyper-CVAD regimen, and 42 with the CALGB 8811 regimen). Median age at diagnosis was 33 years, with 63% males. The most common immunophenotype was CD10-positive common ALL, and 16% have BCR-ABL translocation. Complete response (CR) rate was 88%. After a median follow-up of 32 months (range, 10-72 months), the median survival (MS) was 30 months, and CR duration (CRD) was 28 months. In the multivariate analysis, the presence of BCR-ABL translocation was the only poor prognostic factor with lower MS of 23 months (p<0.01). There was no difference in MS or CRD between the two used regimens.Conclusion. International protocols for adult ALL were successfully applied to our patients. There is no difference in efficacy between Hyper-CVAD and CALGB 8811 regimens. Future protocols for adult ALL should incorporate new targeted agents and minimal residual disease monitoring to improve outcome.

Experience With BFM 95 Pediatric Regimen In Adult ACUTE Lymphoblastic Leukemia

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5015-5015 ◽  
Author(s):  
Hakan Goker ◽  
Eylem Eliacik ◽  
Ayse Isik ◽  
Ibrahim C. Haznedaroglu ◽  
Nilgun Sayinalp ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Complete Remission ◽  
De Novo ◽  
Lymphoblastic Leukemia ◽  
Remission Induction ◽  
Newly Diagnosed ◽  
Adult Acute Lymphoblastic Leukemia ◽  
High Doses ◽  
Dose Reductions

Abstract As treatment of adult acute lymphoblastic leukemia (ALL) is unsatisfactory compared to pediatric disease, there is ongoing interest in the treatment of adult ALL with pediatric regimens. In this context we started to use BFM 95 pediatric regimen (Blood 2008;111:4477) in relapsed adult ALL cases in April 2010 and extended this approach to newly diagnosed non-Burkitt and and non-Ph+ ALL cases aged < 30. Nineteen cases (15 male, 4 female; 11 de novo, 8 relapsed) have been treated during this period in Hacettepe University Med. Ctr. Hematology dept., Ankara, Turkey. Median (range) follow-up durations after BFM 95 regimen and after remission attainment were 4.3 months (1.6-31) and 4.25 (0.4-21.4). Median age was 22 (17-27) in de novo cases and 24 (20-46) in relapsed patients. Three out of 8 relapsed cases had relapsed after allogeneic stem cell transplantation (AlloSCT). Complete remission ratio was 18/19 (95%). One relapsed patient died during induction due to sepsis. The BFM 95 regimen primarily served as a remission induction protocol in relapsed cases. None of these cases completed the treatment protocol. They generally underwent AlloSCT (6 cases) or donor lymphocyte infusion (1 case) shortly after complete remission. Therefore these cases were censored at the time of transplantation in survival analyses. Two out of 11 newly diagnosed patients completed the protocol. In two other cases the treatment was stopped after 2 and 4 consolidation courses for AlloSCT. One de novo patient died in remission. The remaining six de novo cases are still on treatment. Sixteen patients were still alive by the time of last follow-up. Two deaths (during induction and consolidation) and 1 relapse were observed by this time. Median (95% confidence interval) estimated overall and disease-free survival durations were 31 months (not calculable) and 19.4 months (2.6-36.2), respectively. Grade 3-4 non-infectious toxicities were observed only in 5 (%26) patients during treatment. Liver dysfunction, pancreatitis, acute renal failure, and mucositis were occasionally observed. These significant toxicities were due to high doses of methotrexate (5 g/m2) and L-asparaginase (25 000/m2) which were used during early periods of this study. After adequate dose reductions these toxicities were not observed subsequently. Dose reduction for high dose dexamethasone (60 mg/m2) and CMV surveillance were also deemed necessary after one case of fatal CMV reactivation was observed during IIA consolidation protocol. In conclusion, BFM 95 regimen seems to be highly efficacious with a 95% CR rate in young adults. In order to reduce excess toxicities, appropriate dose reductions are necessary for high doses of methotrexate, L-asparaginase and dexamethasone which are applied during various steps of this regimen. However, longer follow-up and more patients and controlled studies are needed in order to reach firm conclusions. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Treatment of adult acute lymphoblastic leukemia with intensive cyclical chemotherapy: a follow-up report

Blood ◽  
1991 ◽  
Vol 78 (11) ◽  
pp. 2814-2822 ◽  
Author(s):  
CA Linker ◽  
LJ Levitt ◽  
M O'Donnell ◽  
SJ Forman ◽  
CA Ries
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Disease Free Survival ◽  
Remission Induction ◽  
Cell Phenotype ◽  
Free Survival ◽  
Prognostic Features ◽  
Adult Acute Lymphoblastic Leukemia ◽  
Disease Free

We treated 109 patients with adult acute lymphoblastic leukemia (ALL) diagnosed by histochemical and immunologic techniques. Patients were excluded only for age greater than 50 years and Burkitt's leukemia. Treatment included a four-drug remission induction phase followed by alternating cycles of noncrossresistant chemotherapy and prolonged oral maintenance therapy. Eighty-eight percent of patients entered complete remission. With a median follow-up of 77 months (range, 48 to 111 months), 42% +/- 6% (SEM) of patients achieving remission are projected to remain disease-free at 5 years, and disease-free survival for all patients entered on study is 35% +/- 5%. Failure to achieve remission within the first 4 weeks of therapy and the presence of the Philadelphia chromosome are associated with a 100% risk of relapse. Remission patients with neither of these adverse features have a 48% +/- 6% probability of remaining in continuous remission for 5 years. Patients with T-cell phenotype have a favorable prognosis with 59% +/- 13% of patients achieving remission remaining disease-free compared with 31% +/- 7% of CALLA-positive patients. Intensive chemotherapy may produce prolonged disease-free survival in a sizable fraction of adults with ALL. Improved therapy is needed, especially for patients with adverse prognostic features.

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