Abstract：
:Adults with acute lymphoblastic leukemia (ALL) do worse than children. From 7/2008 to 12/2014, Nordic and Baltic centers treated 1509 consecutive patients aged 1-45 years with Philadelphia chromosome-negative ALL according to the NOPHO ALL2008 without cranial irradiation. Overall, 1022 patients were of age 1-9 years (A), 266 were 10-17 years (B) and 221 were 18-45 years (C). Sixteen patients (three adults) died during induction. All others achieved remission after induction or 1-3 intensive blocks. Subsequently, 45 patients (12 adults) died, 122 patients relapsed (32 adults) with a median time to relapse of 1.6 years and 13 (no adult) developed a second malignancy. Median follow-up time was 4.6 years. Among the three age groups, older patients more often had higher risk ALL due to T-ALL (32%/25%/9%, P<0.001), KMT2A rearrangements (6%/5%/3%, P<0.001) and higher day 29 residual leukemia for B-lineage (P<0.001), but not T-ALL (P=0.53). Event-free survival rates (pEFS5y) were 89±1% (A), 80±3% (B) and 74±4% (C) with significant differences only for non-high risk groups. Except for thrombosis, pancreatitis and osteonecrosis, the risk of 19 specified toxicities was not enhanced by age above 10 years. In conclusion, a pediatric-based protocol is tolerable and effective for young adults, despite their increased frequency of higher risk features.
journal_name
Leukemiajournal_title
Leukemiaauthors
Toft N,Birgens H,Abrahamsson J,Griškevičius L,Hallböök H,Heyman M,Klausen TW,Jónsson ÓG,Palk K,Pruunsild K,Quist-Paulsen P,Vaitkeviciene G,Vettenranta K,Åsberg A,Frandsen TL,Marquart HV,Madsen HO,Norén-Nyström U,Schmidoi
10.1038/leu.2017.265subject
Has Abstractpub_date
2018-03-01 00:00:00pages
606-615issue
3eissn
0887-6924issn
1476-5551pii
leu2017265journal_volume
32pub_type
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