Contributions
Abstract: PB1363
Type: Publication Only
Session title: Acute lymphoblastic leukemia - Clinical
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 feasibility and results of a pediatric-based protocol (EORTC 58951) in adolescents and young adults.
Methods
From January 2000 to December 2019, 87 patients aged 16 to 30 years with newly diagnosed ALL were treated, in the department of 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 survivals (overall OS and event free EFS).
Results
Eighty-seven AyA ALL were treated with the pediatric protocol. The patients were 56 males (64%) and 31 females. WBC counts more than 100 Giga/l was noted for 25 patients (19%). Immunophenotyping was performed in all patients : 44 B-ALL (51%), 43 T-ALL (49%).
Twenty five patients (29%) were corticoresistant. Seventy eight patients (89%) achieved CR. Five patients failed to respond after 2 courses of chemotherapy and died and 4 patients died during induction chemotherapy as a result of infectious complications. Eleven patients (13%) were treated according AR1 arm, 48 patients (55%) according AR2 arm and 28 (32%) according VHR arm. Twenty eight patients (51.7%) with VHR arm protocol were eligible for allogeneic stem-cell transplantation but, only 10 were allograft: 4 were alive in complete remission and 6 died (by GVH for 2 patients and relapse for 4 patients). Relapse was observed in 22 patients (29%), among them 12 during the first year of treatment. The mean follow up was 128 months. The 10 years OS and EFS were respectively 50% and 49%.
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, were better than adult ALL treated by adult protocol (OS and EFS at 5 years = 35% : local study) but were not satisfactory. Our results were less than those described in the literature (OS ~ 80% and EFS ~ 70%). To further improve our results, it is necessary to expand donor sources such as matched unrelated.
Keyword(s):
Abstract: PB1363
Type: Publication Only
Session title: Acute lymphoblastic leukemia - Clinical
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 feasibility and results of a pediatric-based protocol (EORTC 58951) in adolescents and young adults.
Methods
From January 2000 to December 2019, 87 patients aged 16 to 30 years with newly diagnosed ALL were treated, in the department of 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 survivals (overall OS and event free EFS).
Results
Eighty-seven AyA ALL were treated with the pediatric protocol. The patients were 56 males (64%) and 31 females. WBC counts more than 100 Giga/l was noted for 25 patients (19%). Immunophenotyping was performed in all patients : 44 B-ALL (51%), 43 T-ALL (49%).
Twenty five patients (29%) were corticoresistant. Seventy eight patients (89%) achieved CR. Five patients failed to respond after 2 courses of chemotherapy and died and 4 patients died during induction chemotherapy as a result of infectious complications. Eleven patients (13%) were treated according AR1 arm, 48 patients (55%) according AR2 arm and 28 (32%) according VHR arm. Twenty eight patients (51.7%) with VHR arm protocol were eligible for allogeneic stem-cell transplantation but, only 10 were allograft: 4 were alive in complete remission and 6 died (by GVH for 2 patients and relapse for 4 patients). Relapse was observed in 22 patients (29%), among them 12 during the first year of treatment. The mean follow up was 128 months. The 10 years OS and EFS were respectively 50% and 49%.
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, were better than adult ALL treated by adult protocol (OS and EFS at 5 years = 35% : local study) but were not satisfactory. Our results were less than those described in the literature (OS ~ 80% and EFS ~ 70%). To further improve our results, it is necessary to expand donor sources such as matched unrelated.
Keyword(s):