Ontology highlight
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.
SUBMITTER: Ribera JM
PROVIDER: S-EPMC7131850 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Ribera Josep-Maria JM Morgades Mireia M Montesinos Pau P Tormo Mar M Martínez-Carballeira Daniel D González-Campos José J Gil Cristina C Barba Pere P García-Boyero Raimundo R Coll Rosa R Pedreño María M Ribera Jordi J Mercadal Santiago S Vives Susana S Novo Andrés A Genescà Eulàlia E Hernández-Rivas Jesús-María JM Bergua Juan J Amigo María-Luz ML Vall-Llovera Ferran F Martínez-Sánchez Pilar P Calbacho María M García-Cadenas Irene I Garcia-Guiñon Antoni A Sánchez-Sánchez María-José MJ Cervera Marta M Feliu Evarist E Orfao Alberto A
Cancer medicine 20200205 7
<h4>Background</h4>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).<h4>Methods</h4>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.<h4>Results</h4>From 2008 to 2018, 89 patients (38 adolescents [15-18 years] and 51 young adults [YA, 19-30 years], median age: 20 [15-29] ...[more]