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Outcomes of adult acute lymphoblastic leukemia in the era of pediatric-inspired regimens: a single-center experience

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Abstract

Recent data on acute lymphoblastic leukemia (ALL) treatment with multi-agent chemotherapy showed excellent response in pediatric patients in terms of long-term survival; however, the clinical needs for adult patients are still unmet. Adolescent and young adults’ (AYA) ALL could benefit from a pediatric-inspired regimen with a higher rate of long-term remission. This retrospective study sought to investigate the efficacy of treatment of adult ALL in a single center over the past decade. We analyzed 107 ALL patients with a median age of 26 years (range 15–63 years). Of these, 67.3% received adult regimen and 32.7% received pediatric-inspired regimen. The median follow-up time was 11.6 months (range 1–120). Complete remission (CR) was similarly achieved in over 80% in both schemes. Relapse and refractory rates were higher in the adult group (75%) than in the pediatric (45.7%) group. Two-year disease-free survival in the pediatric group was significantly superior to the adult group (47.1% vs 24.7%, hazard ratio [HR], 1.73, 95% CI 1.22–3.03). Two-year overall survival was higher in pediatric group as compared to adult group (50.8% versus 31.2%, HR 1.52, 95% CI 0.83–2.78). Thus, these findings show that the pediatric-inspired regimen should be considered for the treatment of adult ALL.

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Acknowledgements

The authors would like to thank all medical staff, nurses and paramedic team in Chiang Mai University (CMU) Hospital, Chiang Mai, Thailand for their participation in the care of all patients.

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  1. Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, 110 Inthawaroros Street, Muang, Chiang Mai, 50200, Thailand

    Adisak Tantiworawit, Thanawat Rattanathammethee, Chatree Chai-Adisaksopha, Ekarat Rattarittamrong & Lalita Norasetthada

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  1. Adisak Tantiworawit
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TR and AT were responsible for design of the study, data collection, interpretation of the data and writing the manuscript. TR and CC analyzed the data. All authors contributed to the revision of manuscript and approved the final version.

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Correspondence to Thanawat Rattanathammethee.

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Tantiworawit, A., Rattanathammethee, T., Chai-Adisaksopha, C. et al. Outcomes of adult acute lymphoblastic leukemia in the era of pediatric-inspired regimens: a single-center experience. Int J Hematol 110, 295–305 (2019). https://doi.org/10.1007/s12185-019-02678-y

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