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Several retrospective studies have confirmed that adolescents and young adults (AyA) with acute lymphoblastic leukemia (ALL) treated with pediatric protocols have better outcomes than similarly aged patients treated with adult protocols. We reported results and feasibility of a pediatric-based protocol (EORTC 58951) in adolescents and young adults.

From January 2000 to December 2013, 62 patients aged 16 to 30 years with newly diagnosed ALL were treated, in the department of clinical hematology of Hedi Chaker Hospital, according to the pediatric protocol EORTC 58951. Further leukemia characteristics (Sex, White Blood cell count, Blasts phenotype, Cytogenetic results), we studied the protocol results: response to prophase, risk group stratification (average: AR1 and AR2, very high: VHR), treatment related mortality (TRM), remission rate, relapse rate and 5 years survivals (overall OS, event free EFS and relapse free survival RFS).

Sixty two AyA ALL were treated with the pediatric protocol. The patients were 38 males and 24 females (SR=1.58). 34% had a WBC> 100 G/l. A T blast phenotype was noted in 53% of cases. Nineteen patients (30.5%) had poor response to pophase. Fifty two patients (86%) received AR2 (52%) or VHR (34%) arm induction. Fifty seven patients (97%) achieved CR. Two patients failed to achieve complete respond after 2 courses of chemotherapy.

Induction death was noted in 8%. Consolidation death was noted in 17%. Relapse was observed in 25%. Five years OS, EFS and RFS were respectively 48, 48.5 and 65%.

This study showed that pediatric protocol can offer good results concerning CR and DFS to adolescent and young adult ALL. However OS and EFS, sure better than adult ALL treated during the same period by adult protocol (OS= 14%, EFS=14% and DFS= 40%) was not satisfactory because the high toxic mortality rate.