Increased survival due to lower toxicity for high-risk T-cell acute lymphoblastic leukemia patients in two consecutive pediatric-inspired PETHEMA trials

Pere Barba, Mireia Morgades, Pau Montesinos, Cristina Gil, María Laura Fox, Juana Ciudad, María José Moreno, José González-Campos, Eulàlia Genescà, Daniel Martínez-Carballeira, Rodrigo Martino, Susana Vives, Ramon Guardia, Santiago Mercadal, María Teresa Artola, Antonia Cladera, Mar Tormo, Jordi Esteve, Juan Bergua, Ferran Vall-LloveraJordi Ribera, Pilar Martínez-Sanchez, María Luz Amigo, Arantxa Bermúdez, María Calbacho, Jesús Maria Hernández-Rivas, Evaristo Feliu, Alberto Orfao, Josep María Ribera

Research output: Contribution to journalArticleResearch

6 Citations (Scopus)

Abstract

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Objective and methods: Pediatric-inspired regimens have been adopted by several groups as the treatment strategy for adult patients with acute lymphoblastic leukemia (ALL). Whether subsequent modifications of these protocols have led to an improvement in the outcome of patients is uncertain, especially in T-cell ALL. We analyzed 169 patients with high-risk T-cell ALL included in two consecutive trials of the PETHEMA Group (HR-ALL03 [n = 104] and the more contemporary HR-ALL11 [n = 65]). Results: Patients and disease characteristics were balanced between both groups. Regarding efficacy, we observed a similar complete remission (CR) rate, relapse and disease-free survival (DFS) between both protocols. Patients included in the HR-ALL11 trial had better 2-year overall survival (OS) compared with the HR-ALL03 (65% [95% CI 51%-79%] vs 44% [95% CI 34%-54%], P = 0.026). Regarding toxicity, we observed a better safety profile in the HR-11 protocol. Irrespective of the protocol, patients with good measurable residual disease (MRD) clearance had a promising outcome without allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CR1, with 2-year OS of 67%. Conclusion: Patients with T-cell ALL included in the HR-11 trial showed better OS than patients in the HR-03, mostly driven by a reduction of NRM.
Original languageEnglish
Pages (from-to)79-86
JournalEuropean Journal of Haematology
Volume102
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • acute lymphoblastic leukemia
  • pediatric-inspired
  • T-cell ALL

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