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Results of NOPHO ALL2008 treatment for patients aged 1-45 years with acute lymphoblastic leukemia.

Artikel i vetenskaplig tidskrift
Författare N Toft
H Birgens
Jonas Abrahamsson
L Griškevičius
H Hallböök
M Heyman
T W Klausen
Ó G Jónsson
K Palk
K Pruunsild
P Quist-Paulsen
G Vaitkeviciene
K Vettenranta
A Åsberg
T L Frandsen
H V Marquart
H O Madsen
U Norén-Nyström
K Schmiegelow
Publicerad i Leukemia
Volym 32
Sidor 606–615
ISSN 1476-5551
Publiceringsår 2018
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för pediatrik
Sidor 606–615
Språk en
Länkar dx.doi.org/10.1038/leu.2017.265
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämneskategorier Hematologi, Cancer och onkologi, Pediatrik

Sammanfattning

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.Leukemia advance online publication, 22 September 2017; doi:10.1038/leu.2017.265.

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