Long-term Follow-up Results of Adult Patients with Acute Lymphocytic Leukemia or Lymphoblastic Lymphoma Treated with Short-term, Alternating Non-cross-resistant Chemotherapy: Japan Clinical Oncology Group Study 8702
| Autor: | Kinuko Tajima, Masanori Shimoyama, Tohru Kobayashi, Toshiaki Sai, Atsushi Oyama, Tomomitsu Hotta, Koichi Araki, Shiro Fukuhara, Hironobu Toki, Miyuki Niimi, Shigeru Shirakawa, Naohito Yamaguchi, Makoto Matsumoto, Kijo Deura, Isao Aoki, Haruhiko Fukuda, Mitsuo Kozuru, Masami Nagai, Kensei Tobinai, Tatsuo Abe, Chikara Mikuni, Susumu Konda |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Vincristine Adolescent Cyclophosphamide Prednisolone Gastroenterology Maintenance therapy Internal medicine Acute lymphocytic leukemia Antineoplastic Combined Chemotherapy Protocols medicine Asparaginase Humans Radiology Nuclear Medicine and imaging Survival rate Aged business.industry Lymphoblastic lymphoma General Medicine Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Survival Analysis Chemotherapy regimen Methotrexate Treatment Outcome Oncology Doxorubicin Female business Follow-Up Studies medicine.drug |
| Zdroj: | Japanese Journal of Clinical Oncology. 29:340-348 |
| ISSN: | 1465-3621 0368-2811 |
| Popis: | Background Patients with acute lymphocytic leukemia (ALL) and those with lymphoblastic lymphoma (LBL) have overlapping clinical and immunophenotypic features and they have been treated with the same or very similar chemotherapy regimens. The goal of this multi-institutional phase II trial was to evaluate the therapeutic efficacy of a short-term, six-drug chemotherapy regimen for adult patients with untreated ALL or LBL. Methods Forty-six eligible patients, 41 with ALL and five with LBL, were treated with a short-term (planned total therapy duration; 36-38 weeks), simplified chemotherapy program; two courses of VEPA-L (vincristine, cyclophosphamide, prednisolone, doxorubicin, I-asparaginase plus intrathecal methotrexate and prednisolone) followed by four courses of M-VEPA (methotrexate plus VEPA), without the traditional maintenance therapy using daily 6-mercaptopurine and weekly methotrexate. Results Thirty-six (78%; 95% confidence interval 64-89%) of the 46 eligible patients achieved complete remission (CR). Among the 36 patients who achieved CR, four (11%) died of treatment complications, 26 (72%) relapsed and six (17%) remain alive in continuous CR. The median survival for all 46 eligible patients is 14 months and the median disease-free survival (DFS) for the 36 patients who achieved CR is 11 months. The estimate of the proportion of survival at 7 years of all 46 eligible patients is 15% at a median follow-up time of 96 months and that of DFS of the 36 patients achieving CR is 17% at a median follow-up time of 93 months. Subgroup analysis showed that an elevated serum C-reactive protein (CRP) level, age of 30 years or older, the presence of B-symptom and T-cell phenotype were likely to be associated with shortened survival. Although the observed CR rate (78%) is within the range of satisfaction, the long-term survival rate (15%) is inferior to those of published programs incorporating maintenance therapy. Conclusions A fraction of adult patients with ALL or LBL are curable with a short-term, six-drug chemotherapy regimen. However, this simplified therapy of shorter duration cannot be recommended. |
| Databáze: | OpenAIRE |
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