Acute Lymphoblastic Leukemia in Young Adults Treated with Intensive “Pediatric” Type Protocol

  • Prasanth GanesanEmail author
  • Tenali Gnana Sagar
  • Krishnarathinam Kannan
  • Venkatraman Radhakrishnan
  • Manikandan Dhanushkodi
  • Rajaraman Swaminathan
  • Shirley Sundersingh
  • Trivadi S. Ganesan
Original Article


Young adults with acute lymphoblastic leukemia do better when treated on “pediatric” protocols. Young adults (18–30 years) with Ph-negative ALL treated between 2000 and 2014 were retrospectively analyzed. Two-hundred and thirty-two patients were included [median age 21 years (18–30); 176 (76%) males; median WBC 16,000/cmm]. Protocols used were: BFM 95 (N = 147, 63%), MCP-841 (N = 51, 22%), GMALL (N = 21, 9%), INCTR (N = 9, 4%) and UKALL (N = 4, 2%). Complete remission was achieved in 194/232 (84%). Twenty patients (9%) died due to toxicity which was higher with BFM versus others (18/147 vs. 2/85; p = 0.031). After a median follow-up of 48 months, median RFS and OS were 35.5 months (25–46), and 25 months (18–31) and actuarial RFS and OS (5-years) were 45% (37–53) and 39% (32–46). BFM protocol improved RFS (51 vs. 35%, p = 0.027) but not OS (43 vs. 33%, p = 0.2). The survival outcomes reported are 15–20% lower than those reported from West. Better supportive care and risk-adapted therapy may improve outcomes.


Acute lymphoblastic leukemia India BFM protocol Young adult 



Ms. Vanitha Rajagopalan for helping with collection of data. We acknowledge financial support from Rashtriya Arogya Nidhi, Indian Cancer Society Fund, and the Kalyani Memorial Fund for provided support which partly offset the treatment costs of these patients.


The study was supported by Cancer Institute (WIA) funds. No Grant number is applicable.

Compliance with Ethical Standards

Conflict of interest

None of the authors have any relevant conflicts of interests to declare.

Ethical Approval

This study was a retrospective analysis of outcomes and doesn’t require ethical committee approval as per our Institute policy.

Supplementary material

12288_2017_892_MOESM1_ESM.docx (41 kb)
Supplementary material 1 (DOCX 41 kb)


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Copyright information

© Indian Society of Hematology and Blood Transfusion 2017

Authors and Affiliations

  • Prasanth Ganesan
    • 1
    Email author
  • Tenali Gnana Sagar
    • 1
  • Krishnarathinam Kannan
    • 1
  • Venkatraman Radhakrishnan
    • 1
  • Manikandan Dhanushkodi
    • 1
  • Rajaraman Swaminathan
    • 3
  • Shirley Sundersingh
    • 2
  • Trivadi S. Ganesan
    • 1
  1. 1.Department of Medical OncologyCancer Institute (WIA)ChennaiIndia
  2. 2.Department of PathologyCancer Institute (WIA)ChennaiIndia
  3. 3.Department of Biostatistics and Tumor RegistryCancer Institute (WIA)ChennaiIndia

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