Contributions
Abstract: PB1373
Type: Publication Only
Session title: Acute lymphoblastic leukemia - Clinical
Background
Acute lymphoblastic leukaemia (ALL) in the adolescent and young adults(AYA) population constitute a different group from acute leukaemia in children: by their incidence, which is lower, their particular epidemiological and biological profiles and finally by their prognosis which is worse.However, since the use of pediatric protocols, various studies have shown improvement in their survival.
Aims
This epidemiological study involved 79 adolescent and young adults aged between 15 and 26 years with acute lymphoblastic leukemia (ALL) and treated according to the pediatric protocol EORTC 58951. We will only report the therapeutic results of Philadelphia-negative ALL.
Methods
This is a retrospective study between January 2006 and December 2017 (12 years) at the department of Hematology at Aziza Othmana Hospital.
Results
Median age was 17 years (15-26 years). Sex ratio was 2.95 (59M / 20F).Forty patients (50%) had a tumor syndrome. Central nervous system involvement was noted in 5 patients (6%)
The mean rate of WBC was 60 G (0.8-407 G). WBC rate > 50 G was noted in 33% of patients and> 100G in 21.5%. ALL T was found in 48% of patient vs. 40% of ALL B. Karyotype was normal in 41%. 33 patients had cytogenetic abnormalities (40.5%) among them 6 (9%) had a translocation t (9, 22). Only patients who are Philadelphia negative will be analyzed.
All patients received RM2-VHR induction. Corticosensitivity was studied by a myelogram on D7 in 63 patients (M1: 6 patients, M2: 8 patients, M3: 33 patients and failure: 16 patients) and by a blood smear on D8 in all patients (17.8% of corticosteroid resistance).
Chemo sensitivity was studied by a myelogram on D19 in 71 patients: 15.5% were chemo-resistant. Three patients (4.1%) died in induction.
The remission rate was 93.1%. Minimal Residual Disease (MRD) was carried out in 65 patients: MRD 10-3 in 4 (6%).Thirty-four patients (47.8%) were treated according to the RM2 arm and 37 (52.2%) according to the VHR arm, among which 25 (67.5%) had an indication to transplantation. Allogeneic hematopoietic stem cell transplantation (alloHSCT)was only performed in 8 patients. - One patient died during treatment (1.4%) . Fifteen patients relapsed (22%).
At 36 months: Overall Survival (OS), event-free survival (EFS) and relapse free survival (RFS)are respectively 78.4%, 81.2% and 74.1%.
At 5 years: OS, EFS and RFS are respectively 75.1%, 76.1% and 69.3%
Conclusion
: in our study, we confirm the specific aspects of ALL AYA: presence of tumor syndrome as well as the initial involvement of the central nervous system, high wbc’s rate, the predominance of ALL - T, the higher frequency of Phi positive ALL and CorticO-chemoresistance.
With leukemia regimens based on pediatric protocols, the survival of AYA group has clearly improved compared to patients treated with adult protocols with acceptable toxicity.
Keyword(s):
Abstract: PB1373
Type: Publication Only
Session title: Acute lymphoblastic leukemia - Clinical
Background
Acute lymphoblastic leukaemia (ALL) in the adolescent and young adults(AYA) population constitute a different group from acute leukaemia in children: by their incidence, which is lower, their particular epidemiological and biological profiles and finally by their prognosis which is worse.However, since the use of pediatric protocols, various studies have shown improvement in their survival.
Aims
This epidemiological study involved 79 adolescent and young adults aged between 15 and 26 years with acute lymphoblastic leukemia (ALL) and treated according to the pediatric protocol EORTC 58951. We will only report the therapeutic results of Philadelphia-negative ALL.
Methods
This is a retrospective study between January 2006 and December 2017 (12 years) at the department of Hematology at Aziza Othmana Hospital.
Results
Median age was 17 years (15-26 years). Sex ratio was 2.95 (59M / 20F).Forty patients (50%) had a tumor syndrome. Central nervous system involvement was noted in 5 patients (6%)
The mean rate of WBC was 60 G (0.8-407 G). WBC rate > 50 G was noted in 33% of patients and> 100G in 21.5%. ALL T was found in 48% of patient vs. 40% of ALL B. Karyotype was normal in 41%. 33 patients had cytogenetic abnormalities (40.5%) among them 6 (9%) had a translocation t (9, 22). Only patients who are Philadelphia negative will be analyzed.
All patients received RM2-VHR induction. Corticosensitivity was studied by a myelogram on D7 in 63 patients (M1: 6 patients, M2: 8 patients, M3: 33 patients and failure: 16 patients) and by a blood smear on D8 in all patients (17.8% of corticosteroid resistance).
Chemo sensitivity was studied by a myelogram on D19 in 71 patients: 15.5% were chemo-resistant. Three patients (4.1%) died in induction.
The remission rate was 93.1%. Minimal Residual Disease (MRD) was carried out in 65 patients: MRD 10-3 in 4 (6%).Thirty-four patients (47.8%) were treated according to the RM2 arm and 37 (52.2%) according to the VHR arm, among which 25 (67.5%) had an indication to transplantation. Allogeneic hematopoietic stem cell transplantation (alloHSCT)was only performed in 8 patients. - One patient died during treatment (1.4%) . Fifteen patients relapsed (22%).
At 36 months: Overall Survival (OS), event-free survival (EFS) and relapse free survival (RFS)are respectively 78.4%, 81.2% and 74.1%.
At 5 years: OS, EFS and RFS are respectively 75.1%, 76.1% and 69.3%
Conclusion
: in our study, we confirm the specific aspects of ALL AYA: presence of tumor syndrome as well as the initial involvement of the central nervous system, high wbc’s rate, the predominance of ALL - T, the higher frequency of Phi positive ALL and CorticO-chemoresistance.
With leukemia regimens based on pediatric protocols, the survival of AYA group has clearly improved compared to patients treated with adult protocols with acceptable toxicity.
Keyword(s):