Comparison of intensive, pediatric-inspired therapy with non-intensive therapy in older adults aged 55-65 years with Philadelphia chromosome-negative acute lymphoblastic leukemia.
Leuk Res
; 68: 79-84, 2018 05.
Article
em En
| MEDLINE
| ID: mdl-29574396
ABSTRACT
BACKGROUND AND OBJECTIVE:
The standardization of treatment of older adults with Philadelphia chromosome negative (Ph-) acute lymphoblastic leukemia (ALL) is challenging, especially in the age range of 55-65 years. This study aimed to compare intensive, pediatric-inspired therapy with non-intensive therapy in this population of patients. PATIENTS ANDMETHODS:
The outcomes of 67 patients prospectively included in two consecutive pediatric-inspired intensive protocols (ALL-HR03 and ALL-HR11) from the Spanish PETHEMA Group were compared with those from 44 patients included in a contemporary semi-intensive protocol (ALL-OLD07).RESULTS:
Baseline patient and ALL characteristics were similar in both groups, except for a younger median age in the intensive group (medians 58 vs. 62 years). Patients treated intensively had a higher complete remission rate (85% vs. 64%, pâ¯=â¯0.005), a lower cumulative incidence of relapse (39% [95%CI, 25% to 52%] vs. 60% [95%CI, 38% to 77%], pâ¯=â¯.003), a similar cumulative incidence of treatment-related mortality (28% [95% CI, 18%, 40%] vs. 21% [95% CI, 10%, 34%]) and superior event-free survival at 2 years (37% [95%CI, 25%-49%) vs. 21% [8%-34%], pâ¯=â¯0.002). On multivariable analysis the type of protocol was the only variable with independent significance for event-free survival (HR [95% CI] 2 [1.3, 3], pâ¯=â¯.002).CONCLUSIONS:
Compared with less intensive chemotherapy, pediatric-inspired intensive chemotherapy significantly improves the outcome of older adults with Ph-negative ALL in the age range of 55-65 years.Palavras-chave
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MEDLINE
Assunto principal:
Protocolos de Quimioterapia Combinada Antineoplásica
/
Transplante de Células-Tronco Hematopoéticas
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Leucemia-Linfoma Linfoblástico de Células Precursoras
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article