Outcome of adolescent patients with acute lymphoblastic leukaemia aged 10–14 years as compared with those aged 15–17 years: long-term results of 1094 patients of the AIEOP-BFM ALL 2000 study
| Autor: | Georg Mann, Anja Möricke, Christin Linderkamp, Andishe Attarbaschi, Anna Maria Testi, Peter Bader, Franco Locatelli, M Suttorp, Martin Schrappe, Maria Grazia Valsecchi, Gunnar Cario, Valentino Conter, Rosanna Parasole, Carmelo Rizzari, Melchior Lauten, Maria Caterina Putti, Martin Zimmermann, Andrea Biondi, Daniela Silvestri, Guiseppe Basso, C. Flotho, Peter Lang, Felix Niggli, Elena Barisone, Michaela Kuhlen |
|---|---|
| Přispěvatelé: | Testi, A, Attarbaschi, A, Valsecchi, M, Moricke, A, Cario, G, Niggli, F, Silvestri, D, Bader, P, Kuhlen, M, Parasole, R, Putti, M, Lang, P, Flotho, C, Mann, G, Rizzari, C, Barisone, E, Locatelli, F, Linderkamp, C, Lauten, M, Suttorp, M, Zimmermann, M, Basso, G, Biondi, A, Conter, V, Schrappe, M |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
0301 basic medicine Cancer Research Pediatrics medicine.medical_specialty Neoplasm Residual Adolescent acute lymphoblastic leukaemia Prognosi medicine.medical_treatment Disease Disease-Free Survival Treatment failure Targeted therapy adolescents prognosis relapse treatment-related death 03 medical and health sciences 0302 clinical medicine Age groups Recurrence Antineoplastic Combined Chemotherapy Protocols medicine Humans Child Prospective cohort study Retrospective Studies Incidence Optimal treatment Long term results Precursor Cell Lymphoblastic Leukemia-Lymphoma 030104 developmental biology Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA Oncology 030220 oncology & carcinogenesis Lymphoblastic leukaemia Female |
| Popis: | Background: Adolescents (aged 10–17 years) with acute lymphoblastic leukaemia (ALL) have unfavourable disease features and an inferior outcome when compared with younger children, but it is still unclear if differences in disease biology and prognosis exist between adolescents older or younger than 15 years. Methods: We retrospectively analysed outcomes of 1094 adolescents with ALL, aged 10–17 years, treated within the AIEOP-BFM ALL 2000 trial, overall and by the age groups 10–14 and 15–17 years. Findings: Compared with younger children (aged 1–9 years, n = 3647), adolescents had a statistically inferior 5-year event-free survival (EFS) [74.6% (1.3) vs. 84.4% (0.6)] and overall survival (OS) [83.4% (1.1) vs. 92.7% (0.4); p < 0.001]. Clinical and biological disease characteristics did not differ between the two subgroups of adolescents, including minimal residual disease (MRD) results during initial therapy, except for ETV6-RUNX1 frequency and gender. With a median follow-up of 8.8 years, the 5-year EFS and OS were 76.2% (1.5) and 84.9% (1.3), respectively, for those aged 10–14 years and 70.0% (2.8) and 78.8% (2.5) for those aged 15–17 years (p = 0.06; 0.05). There was no significant difference in the cumulative incidence of relapses [17.8% (1.4) and 18.3% (2.4); p = 0.98], while the incidence of treatment-related deaths as a first event was 2.6% (0.6) versus 7.4% (1.6) (p < 0.001) with, in particular, a higher incidence in the high-risk arm. Interpretation: Further prospective studies and biological investigations are required to define optimal treatment for adolescents, in particular for those aged 15–17 years. Newer agents (immunotherapy, targeted therapy) in early treatment phases of patients at higher risk of treatment failure could replace most toxic treatment elements, with the aim of reducing both toxicity and the risk of relapses. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|