Adult Philadelphia-Positive Acute Lymphoblastic Leukemia: A Single-Institution Experience in Limited-Resource Setting.

Autor: Antapura RH; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Vaibhav AB; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Dasappa L; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Jacob LA; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Sureshbabu MC; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Lokesh KN; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Rajeev LK; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Saldanha SC; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India., Venkatesh T; Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.
Jazyk: angličtina
Zdroj: South Asian journal of cancer [South Asian J Cancer] 2023 Apr 10; Vol. 13 (3), pp. 203-206. Date of Electronic Publication: 2023 Apr 10 (Print Publication: 2024).
DOI: 10.1055/s-0041-1728224
Abstrakt: L. K. Rajeev Background  Adult Philadelphia-positive (Ph + ) acute lymphoblastic leukemia (ALL) is a distinct entity with poor prognosis. Treatment with tyrosine kinase inhibitors improved responses but still with poor outcomes. We evaluated treatment outcomes in these patients treated in limited-resource settings in the absence of availability of allogeneic stem cell transplantation (ASCT). Materials and Methods  We studied case record files of the adult patients diagnosed with Ph+ ALL. Results  A total of 18 patients were evaluated retrospectively. The median age of presentation was 28 years. Male-to-female ratio was 1:1. Patients presented with fever and fatigue. Six patients (33.33%) presented with cervical lymphadenopathy. Clinical splenomegaly was present in 16 (88.88%) patients on palpation, whereas on ultrasonographic evaluation, all 18 patients had splenomegaly. The median size of the spleen was 15 cm. Hepatomegaly was seen in 5 (27%) patients. All 18 patients had anemia at the time of presentation. Leukocytosis was seen in 17 (94.44%) patients, whereas 1 (5.56%) patient presented with low total leukocyte count. The median platelet count at the time of presentation was 30,000/mm. 3 On peripheral smear, median number of blast cells was 55%, and on bone marrow aspiration samples, median blast percentage seen was 70%. Conventional cytogenetics was done in all the patients on bone marrow aspiration samples. Ten patients (55.55%) had t(9;22) - Ph chromosome. One patient (5.56%) on cytogenetics showed double Ph chromosome. The median value of breakpoint cluster region-ABL1 transcript in IS% was 13%. Seventeen (94.44%) received ALL protocol (BFM95) along with tyrosine kinase inhibitor (imatinib). One (5.56%) patient refused aggressive cytotoxic chemotherapy. No patient underwent ASCT. The median duration of follow-up was 7.5 months, ranging from 3 to 16 months. Median overall survival (OS) was 7.5 months and 2-year OS was 33.33%. Conclusion  Poor prognosis of this disease, especially in the absence of ASCT, remains a major challenge in the treatment.
Competing Interests: Conflict of Interest None declared.
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Databáze: MEDLINE
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