Treating Adult Acute Lymphoblastic Leukemia in Brazil-Increased Early Mortality Using a German Multicenter Acute Lymphoblastic Leukemia-based regimen
| Autor: | Vanderson Rocha, Wellington Fernandes da Silva Junior, Valeria Buccheri, Elvira Deolinda Rodrigues Pereira Velloso, Andrezza Bertolaci Medina, Patricia Eiko Yamakawa |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Cancer Research Pediatrics medicine.medical_specialty Adolescent International Cooperation medicine.medical_treatment Lymphoblastic Leukemia Induction Phase Disease-Free Survival Sepsis Young Adult 03 medical and health sciences 0302 clinical medicine Patient age Germany Antineoplastic Combined Chemotherapy Protocols medicine Humans Longitudinal Studies Mortality Aged Retrospective Studies Salvage Therapy Chemotherapy business.industry Remission Induction Hematology Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Survival Rate Regimen Oncology 030220 oncology & carcinogenesis Adult Acute Lymphoblastic Leukemia BRASIL Female business Brazil 030215 immunology Rare disease |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| Popis: | Background Acute lymphoblastic leukemia (ALL) in adults is an invariably aggressive and rare disease. Its treatment is based on the use of multidrug regimens, which have been improved since the 1970s. Few published data are available on the results of adult ALL treatment in Latin America. Materials and Methods We retrospectively analyzed the data from 59 patients with ALL treated from 2009 to 2015 at Hospital of Clinics of University of Sao Paulo, using an adapted German Multicenter ALL (GMALL) protocol (07/2003). Results The median patient age was 35 years (range, 16-71 years), with 76% of new cases of B-cell lineage. Central nervous system involvement was present in 29%. Most patients were in the high-risk group, using the original GMALL criteria (68%). The early death rate was 17%, preventing early evaluation of the response in these patients. Despite a reasonable complete remission rate (76%), most patients eventually died of sepsis, especially during the induction phase and salvage regimens. The median overall survival was 17 months. Conclusion Intensified chemotherapy protocols for adult ALL have succeeded in achieving better survival rates in adults, especially younger adults. The low overall survival found with GMALL in Brazil's public hospital denotes the importance of optimizing the adaptations of international protocols for treatment of ALL in nondeveloped countries and, in parallel, improving supportive care in public services. |
| Databáze: | OpenAIRE |
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