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Long-term outcomes of modified BFM-95 regimen in adults with newly diagnosed standard-risk acute lymphoblastic leukemia: a retrospective single-center study

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Abstract

The standard treatment for adult acute lymphoblastic leukemia (ALL) is undefined. Patients with newly diagnosed standard-risk ALL at a single institution were retrospectively analyzed. From 2010 to 2017, 46 patients were treated using the modified Berlin–Frankfurt–Münster (BFM)-ALL-95 regimen. Hematologic and molecular complete remission (CR) rates of 91.3% and 76.1% were achieved. The 5-year event-free survival (EFS) and overall survival (OS) rates for all patients in the cohort were 58.0% (95% confidence interval, 42.1–73.9%) and 66.7% (95% CI, 51.4–82.0%), respectively. No patient presented with central nervous system involvement after CR in this study. This condition could be related to four doses of high-dose methotrexate (MTX) every 3 months during the maintenance phase. Multivariate analysis revealed that minimal residual disease positive and time interval between induction IA and Protocol M of more than 70 days were independent adverse factors for EFS and OS. One or more instances of grade 4 myelosuppression occurred during induction therapy. Nonhematological side effects were mild. No toxicity-related deaths were observed in the entire cohort. The data indicated that the modified regimen is well tolerated and can produce the promising outcomes in Chinese adults with standard-risk ALL.

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Acknowledgements

We thank the patients and their families and all the investigators, including the physicians, nurses, and laboratory technicians in this study.

Funding

This study was funded by the following funds: PhD Start-up Fund of Natural Science Foundation of Guangdong Province (contract/Grant number: 2017A030310193); Young Teachers’ Cultivation Project of Sun Yat-Sen University (No. 16ykpy30); Science and Technology Projects of Guangdong Province (contract/Grant numbers: 2014A020212577) and National Natural Science Foundation of China (contract/Grant number: 81700148)

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Author notes

  1. Chun Li and Xiuyu Cai contributed equally to this work.

Authors and Affiliations

  1. Department of Hematological Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China

    Chun Li, Xiaoqin Chen, Yang Liang, Zhongjun Xia & Hua Wang

  2. Department of VIP Region, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China

    Xiuyu Cai

Authors
  1. Chun Li
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  2. Xiuyu Cai
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Correspondence to Zhongjun Xia or Hua Wang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee and the institutional review board of Sun Yat-Sen University Cancer Center and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Li, C., Cai, X., Chen, X. et al. Long-term outcomes of modified BFM-95 regimen in adults with newly diagnosed standard-risk acute lymphoblastic leukemia: a retrospective single-center study. Int J Hematol 110, 458–465 (2019). https://doi.org/10.1007/s12185-019-02703-0

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  • DOI: https://doi.org/10.1007/s12185-019-02703-0

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