| Autor: |
Toft, N, Birgens, H, Abrahamsson, J, Griškevicius, L, Hallböök, H, Heyman, M, Klausen, T W, Jónsson, ÓG, Palk, K, Pruunsild, K, Quist-Paulsen, P, Vaitkeviciene, G, Vettenranta, K, Åsberg, A, Frandsen, T L, Marquart, H V, Madsen, H O, Norén-Nyström, U, Schmiegelow, K |
| Zdroj: |
Leukemia; March 2018, Vol. 32 Issue: 3 p606-615, 10p |
| Abstrakt: |
Adults with acute lymphoblastic leukemia (ALL) do worse than children. From 7/2008 to 12/2014, Nordic and Baltic centers treated 1509 consecutive patients aged 1–45 years with Philadelphia chromosome-negative ALL according to the NOPHO ALL2008 without cranial irradiation. Overall, 1022 patients were of age 1–9 years (A), 266 were 10–17 years (B) and 221 were 18–45 years (C). Sixteen patients (three adults) died during induction. All others achieved remission after induction or 1–3 intensive blocks. Subsequently, 45 patients (12 adults) died, 122 patients relapsed (32 adults) with a median time to relapse of 1.6 years and 13 (no adult) developed a second malignancy. Median follow-up time was 4.6 years. Among the three age groups, older patients more often had higher risk ALL due to T-ALL (32%/25%/9%, P<0.001), KMT2A rearrangements (6%/5%/3%, P<0.001) and higher day 29 residual leukemia for B-lineage (P<0.001), but not T-ALL (P=0.53). Event-free survival rates (pEFS5y) were 89±1% (A), 80±3% (B) and 74±4% (C) with significant differences only for non-high risk groups. Except for thrombosis, pancreatitis and osteonecrosis, the risk of 19 specified toxicities was not enhanced by age above 10 years. In conclusion, a pediatric-based protocol is tolerable and effective for young adults, despite their increased frequency of higher risk features. |
| Databáze: |
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