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Title: A pediatric regimen for adolescents and young adults with Philadelphia chromosome‐negative acute lymphoblastic leukemia: Results of the ALLRE08 PETHEMA trial
Author: Ribera, Josep Maria
Morgades, Mireia
Montesinos, Pau
Tormo, Mar
Martínez Carballeira, Daniel
González Campos, José
Gil, Cristina
Barba, Pere
García Boyero, Raimundo
Coll, Rosa
Pedreño, María
Ribera, Jordi
Mercadal, Santiago
Vives, Susana
Novo, Andrés
Genescà, Eulàlia
Hernández Rivas, Jesús María
Bergua, Juan
Amigo, María‐luz
Vall Llovera, Ferran
Martínez Sánchez, Pilar
Calbacho, María
García Cadenas, Irene
Garcia Guiñon, Antoni
Sánchez Sánchez, María José
Cervera, Marta
Feliu, Evarist
Orfao, Alberto
Keywords: Leucèmia limfocítica crònica
Chronic lymphocytic leukemia
Issue Date: 1-Apr-2020
Publisher: John Wiley & Sons Ltd.
Abstract: Background: Pediatric-based or -inspired trials have improved the prognosis of adolescents and young adults (AYA) with Philadelphia chromosome-negative (Ph-neg) acute lymphoblastic leukemia (ALL). Methods: This study reports the results of treatment of the ALLRE08 trial, a full pediatric trial for AYA aged 15-30 years with standard-risk (SR) ALL. Results: From 2008 to 2018, 89 patients (38 adolescents [15-18 years] and 51 young adults [YA, 19-30 years], median age: 20 [15-29] years) were enrolled in the ALLRE08 trial. The complete response (CR) was 95%. Twenty-two patients were transferred to a high-risk (HR) protocol because of poor marrow response on day 14 (n = 20) or high-level of end-induction minimal residual response (MRD ≥ 0.25%, n = 2). Cumulative incidence of relapse (CIR) at 5 years was 35% (95%CI: 23%-47%), with significant differences between adolescents and YA: 13% (4%-28%) vs 52% (34%-67%), P = .012. No treatment-related mortality was observed in 66/66 patients following the ALLRE08 trial vs 3/23 patients moved to a HR trial. The estimated 5-year overall survival (OS) was 74% (95%CI: 63%-85%), with significantly higher rates for adolescents vs YA: 87% (95%CI: 74%-100%) vs 63% (46%-80%), P = .021. Although CIR or OS were lower in patients who were transferred to a HR trial, the differences were not statistically significant (CIR: 34% [21%-47%] vs 37% [14%-61%]; OS: 78% [66%-90%] vs 61% [31%;91%]). Conclusion: A full pediatric trial is feasible and effective for AYA with Ph-neg, SR-ALL, with better results for adolescents than for YA. Outcome of patients with poor early response rescued with a HR trial was not significantly inferior.
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It is part of: Cancer Medicine, 2020, vol. 9, num. 7, p. 2317-2329
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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