TY - JOUR
T1 - A pediatric regimen for adolescents and young adults with Philadelphia chromosome-negative acute lymphoblastic leukemia :
T2 - Results of the ALLRE08 PETHEMA trial
AU - Ribera, Jose-Maria
AU - Morgades, Mireia
AU - Montesinos, Pau
AU - Tormo, Mar
AU - Martínez-Carballeira, Daniel
AU - González-Campos, José
AU - Gil, Cristina
AU - Barba, Pere
AU - García-Boyero, Raimundo
AU - Coll, Rosa
AU - Pedreño, María
AU - Ribera Salas, Jordi
AU - Mercadal, Santiago
AU - Vives Polo, Susana
AU - Novo, Andrés
AU - Genescà, Eulàlia
AU - Hernández Rivas, Jesús María
AU - Bergua Burgues, Juan Miguel
AU - Amigo, María-Luz
AU - Vall-Llovera, Ferran
AU - Martínez-Sánchez, Pilar
AU - Calbacho, Maria
AU - Garcia Cadenas, Irene
AU - Garcia-Guiñón, Antoni
AU - Sánchez-Sánchez, María-José
AU - Cervera, Marta
AU - Feliu Frasnedo, Evarist
AU - Orfao, Alberto
PY - 2020
Y1 - 2020
N2 - 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). 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. 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%]). 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. A full pediatric trial is feasible and effective for adolescent and young adults with acute lymphoblastic leukemia, with better results for adolescents than for young adults. The outcome of patients showing poor early response was not significantly inferior than that observed for good responders after being transferred to a high-risk trial.
AB - 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). 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. 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%]). 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. A full pediatric trial is feasible and effective for adolescent and young adults with acute lymphoblastic leukemia, with better results for adolescents than for young adults. The outcome of patients showing poor early response was not significantly inferior than that observed for good responders after being transferred to a high-risk trial.
KW - Acute lymphoblastic leukemia
KW - Adolescents and young adults
KW - Pediatric treatment
UR - https://www.scopus.com/pages/publications/85079063857
U2 - 10.1002/cam4.2814
DO - 10.1002/cam4.2814
M3 - Article
C2 - 32022463
SN - 2045-7634
VL - 9
SP - 2317
EP - 2329
JO - Cancer Medicine
JF - Cancer Medicine
ER -