Adult acute lymphoblastic leukemia. Comparative study of the clinicobiological features and response to treatment based on age in a group of 41 patients

E. Tuset, J. M. Ribera, I. Granada, J. T. Navarro, D. Vela, J. Juncá, A. Flores, F. Millá, E. Feliu

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Abstract

Background: The aim of this study was to analyze the influence of age on the clinical and biological features as well as the results of treatment in 41 adult patients with acute lymphoblastic leukemia (ALL). Patients and methods: The patients diagnosed with ALL from January 1989 to October 1995 in a single center were studied. Two groups of patients were analyzed based on age. The main clinical, hematologic and biochemical parameters, morphologic subtype and immunologic phenotype and the results of the cytogenetic study were analyzed. Likewise, the attainment of complete remission (CR), its duration and overall survival (OS) were also studied. Comparison of the cited variables and the results of treatment among the two groups of patients was performed. Results: Group I was made of 19 (11 males, 8 females) patients ≤50 years of age (mean age 65 ± 9 years). Group II included 22 patients (11 males and 11 females) with a mean age of 28 ± 11 years. Significant differences were only observed between the two groups in regard to the proportion of peripheral blood blasts (p < 0.02), serum LDH values (p = 0.05) and the performance status at the time of diagnosis (p < 0.00007). In the patients in group I cytogenetic alterations were more frequent (10/16 vs 4/20, p < 0.02), being mainly pseudodiploid. Complete remission was achieved in 7/16 patients in gruop I and in 17/22 in group II (p < 0.02). The median duration of CR was 34 and 18 months, respectively. The median OS was 7 months in group 1 and 15 months in group II with an estimated survival at 5 years of 0% in group I and 38% in group II (p < 0.05). Conclusions: Patients with acute lymphoblastic leukemia over the age of 50 years have a worse general status and more cytogenetic alterations (particularly structural) than younger adult patients, presenting a lower probability of achieving complete remission and a shorter survival.
Original languageEnglish
Pages (from-to)401-404
JournalMedicina Clinica
Volume107
Issue number11
Publication statusPublished - 5 Oct 1996

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