OUTCOME OF ADOLESCENTS AND YOUNG ADULTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA TREATED WITH PEDIATRIC PROTOCOL: MONOCENTRIC STUDY
(Abstract release date: 05/18/17)
EHA Library. Frikha I. 05/18/17; 182353; PB1639
Dr. Imen Frikha
Contributions
Contributions
Abstract
Abstract: PB1639
Type: Publication Only
Background
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.
Aims
We reported results and feasibility of a pediatric-based protocol (EORTC 58951) in adolescents and young adults.
Methods
From January 2000 to December 2015, 72 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), remission rate, death rate, relapse rate and 5 years survivals (overall OS and event free EFS).
Results
Seventy two AyA ALL were treated with the pediatric protocol. The patients were 45 males and 27 females (SR=1.66). A WBC> 100 G/l was noted in 32%. A T blast phenotype was noted in 53% of cases. Twenty two patients (30%) were PPR. Nine patients (13%) were treated according AR1 arm, 39 patients (54%) according AR2 arm and 24 patients (33%) according VHR arm induction. CR rate was 87% after one course and 94% after 2 courses. Induction death was noted in 3% and post-induction death was noted in 13%. Twenty four patients treated with VHR arm protocol were eligible for allogenic stem-cell transplantation (SCT), among them 15 patients had a familial donor and 10 patients were allograft (42%) and only 4 patients still in CR (2 patients died by GVH and 4 patients relapsed). Relapse was observed in 22 patients (32%), among them 12 during the first year of treatment. The median follow up was 101 months (8,4 years). The five years OS and EFS were respectively 50 and 50.4%.
Conclusion
The results of this pediatric based study show that response to therapy and prognostic in adolescent and young adults were better than those treated with adult protocols and tolerability of chemotherapy is acceptable. However OS and EFS, better than adult ALL treated by adult protocol (OS= 14%, EFS=14%: local study) was not satisfactory because the high toxic mortality rate.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): Young adult, Adolescents, Acute lymphoblastic leukemia
Abstract: PB1639
Type: Publication Only
Background
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.
Aims
We reported results and feasibility of a pediatric-based protocol (EORTC 58951) in adolescents and young adults.
Methods
From January 2000 to December 2015, 72 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), remission rate, death rate, relapse rate and 5 years survivals (overall OS and event free EFS).
Results
Seventy two AyA ALL were treated with the pediatric protocol. The patients were 45 males and 27 females (SR=1.66). A WBC> 100 G/l was noted in 32%. A T blast phenotype was noted in 53% of cases. Twenty two patients (30%) were PPR. Nine patients (13%) were treated according AR1 arm, 39 patients (54%) according AR2 arm and 24 patients (33%) according VHR arm induction. CR rate was 87% after one course and 94% after 2 courses. Induction death was noted in 3% and post-induction death was noted in 13%. Twenty four patients treated with VHR arm protocol were eligible for allogenic stem-cell transplantation (SCT), among them 15 patients had a familial donor and 10 patients were allograft (42%) and only 4 patients still in CR (2 patients died by GVH and 4 patients relapsed). Relapse was observed in 22 patients (32%), among them 12 during the first year of treatment. The median follow up was 101 months (8,4 years). The five years OS and EFS were respectively 50 and 50.4%.
Conclusion
The results of this pediatric based study show that response to therapy and prognostic in adolescent and young adults were better than those treated with adult protocols and tolerability of chemotherapy is acceptable. However OS and EFS, better than adult ALL treated by adult protocol (OS= 14%, EFS=14%: local study) was not satisfactory because the high toxic mortality rate.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): Young adult, Adolescents, Acute lymphoblastic leukemia
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