Skip to main content
SpringerLink
Log in

Treatment of Adult ALL According to Protocols of the German Multicenter Study Group for Adult ALL (GMALL)

  • Chapter
Acute Leukemias

Part of the book series: Hematologic Malignancies ((HEMATOLOGIC))

Abstract

Since 1978 more than 4500 adult ALL patients have been treated according to the protocols of the German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia (GMALL). GMALL protocols are administered in hospitals all over Germany and the number of participating centers in Germany increased from 25 in 1981 to 120 in the most recent trial. Up to now seven consecutive trials for adult de novo ALL have been conducted. The major aim of all trials was the improvement of remission duration and survival of adult ALL patients, detailed diagnostic characterization, the development of prognostic models and the evaluation of risk-adapted, individualized and targeted treatment strategies. The time-periods and further aims of these studies are briefly summarized in Table 13.1.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Gökbuget N, Hoelzer D, Arnold R, et al. (2000) Treatment of adult ALL according to the protocols of the German Multicenter Study Group for Adult ALL (GMALL). Hemat/Oncol Clin North Am 14:1307–1325

    Article  Google Scholar 

  2. Hoelzer D, Thiel E, Löffler H, et al. (1984) Intensified therapy in acute lymphoblastic and acute undifferentiated leukemia in adults. Blood 64:38–47

    PubMed  CAS  Google Scholar 

  3. Hoelzer D, Thiel E, Ludwig WD, et al. (1993) Follow-up of the first two successive German multicentre trials for adult ALL (01/81 and 02/84). German Adult ALL Study Group. Leukemia 7(Suppl 2):S130–S134

    PubMed  Google Scholar 

  4. Hoelzer D, Thiel E, Löffler H, et al. (1988) Prognostic factors in a multicenter study for treatment of acute lymphoblastic leukemia in adults. Blood 71:123–131

    PubMed  CAS  Google Scholar 

  5. Gökbuget N, Arnold R, Buechner TH, et al. (2001) Intensification of induction and consolidation improves only subgroups of adult ALL: Analysis of 1200 patients in GMALL study 05/93. Blood 98:802a (abstr)

    Google Scholar 

  6. Gökbuget N, Baur K-H, Beck J, et al. (2005) Dexamethasone dose and schedule significantly influences remission rate and toxicity of induction therapy in adult acute lymphoblastic leukemia (ALL): Results of the GMALL pilot trial 06/99 [abstract]. Blood 106:1832

    Google Scholar 

  7. Arnold R, Bunjes D, Ehninger G, et al. (2002) Allogeneic stem cell transplantation from HLA-identical sibling donor in high risk ALL patients is less effective than transplantation from unrelated donors. Blood 100:77a (abstr 279)

    Google Scholar 

  8. Kiehl MG, Kraut L, Schwerdtfeger R, et al. (2004) Outcome of allogeneic hematopoietic stem-cell transplantation in adult patients with acute lymphoblastic leukemia: No difference in related compared with unrelated transplant in first complete remission. J Clin Oncol 22:2816–2825

    Article  PubMed  Google Scholar 

  9. Arnold R, Beelen D, Bunjes D, et al. (2003) Phenotype predicts outcome after allogeneic stem cell transplantation in adult high risk ALL patients. Blood 102:(abstr #1719)

    Google Scholar 

  10. Ottmann OG, Druker BJ, Sawyers CL, et al. (2002) A phase II study of imatinib mesylate (Glivec) in patients with relapsed or refractory Philadelphia chromosome-positive acute lymphoid leukemias. Blood 100:1965–1971

    Article  PubMed  CAS  Google Scholar 

  11. Wassmann B, Pfeifer H, Scheuring U, et al. (2002) Therapy with imatinib mesylate (Glivec) preceding allogeneic stem cell transplantation (SCT) in relapsed or refractory Philadelphia-positive acute lymphoblastic leukemia (Ph+ALL). Leukemia 16:2358–2365

    Article  PubMed  CAS  Google Scholar 

  12. Scheuring UJ, Pfeifer H, Wassmann B, et al. (2003) Early minimal residual disease (MRD) analysis during treatment of Philadelphia chromosome/Bcr-Abl-positive acute lymphoblastic leukemia with the Abl-tyrosine kinase inhibitor imatinib (STI571). Blood 101:85–90

    Article  PubMed  CAS  Google Scholar 

  13. Wassmann B, Pfeifer H, Gökbuget N, et al. (2006) Alternating versus concurrent schedules of Imatinib and chemotherapy as frontline therapy for Philadelphia-positive acute lymphoblastic leukemia (Ph+ALL). Blood 108:1469–1477

    Article  PubMed  CAS  Google Scholar 

  14. Wassmann B, Pfeifer H, Stadler M, et al. (2005) Early molecular response to posttransplantation imatinib determines outcome in MRD+ Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL). Blood 106:458–463

    Article  PubMed  CAS  Google Scholar 

  15. Gökbuget N, de Wit M, Gerhardt A, et al. (2000) Results of a shortened, dose reduced treatment protocol in elderly patients with acute lymphoblastic leukemia (ALL). Blood 96:3104a (abstr)

    Google Scholar 

  16. Ottmann OG, Wassmann B, Pfeifer H, et al. (2007) Imatinib compared with chemotherapy as front-line treatment of elderly patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL). Cancer 109:2068–2076

    Article  PubMed  CAS  Google Scholar 

  17. Hofmann WK, de Vos S, Elashoff D, et al. (2002) Relation between resistance of Philadelphia-chromosome-positive acute lymphoblastic leukaemia to the tyrosine kinase inhibitor STI571 and gene-expression profiles: A gene-expression study. Lancet 359: 481–486

    Article  PubMed  CAS  Google Scholar 

  18. Pfeifer H, Wassmann B, Pavlova A, et al. (2007) Kinase domain mutations of BCR-ABL frequently precede imatinib-based therapy and give rise to relapse in patients with de novo Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL). Blood 110:727–734

    Article  PubMed  CAS  Google Scholar 

  19. Hoelzer D, Ludwig W-D, Thiel E, et al. (1996) Improved outcome in adult B-cell acute lymphoblastic leukemia. Blood 87:495–508

    PubMed  CAS  Google Scholar 

  20. Hoelzer D, Arnold R, Diedrich H, et al. (2002) Successful treatment of Burkitt’s NHL and other high-grade NHL according to a protocol for mature B-ALL. Blood 100:159a (abstr 595)

    Article  Google Scholar 

  21. Hoelzer D, Baur K-H, Giagounidis A, et al. (2003) Short intensive chemotherapy with rituximab seems successful in Burkitt NHL, mature B-ALL and other high-grade B-NHL. Blood 102: (abstr 236)

    Google Scholar 

  22. Hoffmann C, Wolf E, Wyen C, et al. (2006) AIDS-associated Burkitt or Burkitt-like lymphoma: Short intensive polychemotherapy is feasible and effective. Leuk Lymphoma 47:1872–1880

    Article  PubMed  Google Scholar 

  23. Thiel E, Hoelzer D, Dörken B, et al. (1987) Clinical relevance of blast cell phenotype as determined with monoclonal antibodies in acute lymphoblastic leukemia of adults. Haematol Blood Transf 30:95–103

    CAS  Google Scholar 

  24. Bene MC, Castoldi G, Knapp W, et al. (1995) Proposal for the immunological classification of acute leukemias. Leukemia 9:1783–1786

    PubMed  CAS  Google Scholar 

  25. Ludwig WD, Raghavachar A, Thiel E (1994) Immunophenotypic classification of acute lymphoblastic leukemia. Bailliere’s Clin Haematol 7(2):235

    Article  CAS  Google Scholar 

  26. Thiel E, Kranz BR, Raghavachar A, et al. (1989) Prethymic phenotype and genotype of pre-T(CD+/ER-)-cell leukemia and its clinical significance within adult acute lymphoblastic leukemia. Blood 73:1247–1258

    PubMed  CAS  Google Scholar 

  27. Hoelzer D, Arnold R, Freund M, et al. (1999) Characteristics, outcome and risk factors in adult T-lineage acute lymphoblastic leukemia (ALL). Blood 94:2926a

    Google Scholar 

  28. Ludwig WD (1996) Immunophenotypic features of childhood and adult acute lymphoblastic leukemia (ALL): experience of the German Multicentre Trials ALL-BFM and GMALL. Leuk Lymphoma 13:71

    Article  Google Scholar 

  29. Gleissner B, Gökbuget N, Rieder H, et al. (2005) CD10-negative pre-B acute lymphoblastic leukemia (ALL): A distinct high-risk subgroup of adult ALL associated with a high frequency of MLL aberrations. Results of the German Multicenter Trials for Adult ALL (GMALL). Blood 106:4054–4056

    Article  PubMed  CAS  Google Scholar 

  30. Gleissner B, Gökbuget N, Bartram CR, et al. (2002) Leading prognostic relevance of the BCR-ABL translocation in adult acute Blineage lymphoblastic leukemia: A prospective study of the German Multicenter Trial Group and confirmed polymerase chain reaction analysis. Blood 99:1536–1543

    Article  PubMed  CAS  Google Scholar 

  31. Burmeister T, Gökbuget N, Reinhardt R, et al. (2006) NUP214-ABL1 in adult T-ALL: The GMALL study group experience. Blood 108:3556–3559

    Article  PubMed  CAS  Google Scholar 

  32. Burmeister T, Marschalek R, Schneider B, et al. (2006) Monitoring minimal residual disease by quantification of genomic chromosomal breakpoint sequences in acute leukemias with MLL aberrations. Leukemia 20:451–457

    Article  PubMed  CAS  Google Scholar 

  33. Baak U, Burmeister T, Gökbuget N, et al. (2004) Prognostic impact of the expression of the TLX1 (HOX11) and TLX3 (HOX11L2) oncogenes in adult ALL: Experience of the German Multicenter Acute Lymphoblastic Leukemia (GMALL) Therapy Study Group. Session Type: Poster Session 229-I. Blood 104:#1075

    Google Scholar 

  34. Baldus CD, Burmeister T, Martus P, et al. (2006) High expression of the ETS transcription factor ERG predicts adverse outcome in acute T-lymphoblastic leukemia in adults. J Clin Oncol 24:4714–4720

    Article  PubMed  CAS  Google Scholar 

  35. Baldus CD, Martus P, Burmeister T, et al. (2007) Low ERG and BAALC expression identifies a new subgroup of adult acute T-lymphoblastic leukemia with a highly favorable outcome. J Clin Oncol (accepted)

    Google Scholar 

  36. Bruggemann M, Raff T, Flohr T, et al. (2006) Clinical significance of minimal residual disease quantification in adult patients with standard-risk acute lymphoblastic leukemia. Blood 107:1116–1123

    Article  PubMed  CAS  Google Scholar 

  37. Raff T, Gökbuget N, Luschen S, et al. (2007) Molecular relapse in adult standard-risk ALL patients detected by prospective MRD monitoring during and after maintenance treatment: Data from the GMALL 06/99 and 07/03 trials. Blood 109:910–915

    Article  PubMed  CAS  Google Scholar 

  38. Gökbuget N, Raff R, Brugge-Mann M, et al. (2004) Risk/MRD adapted GMALL trials in adult ALL. Ann Hematol 83(Suppl 1): S129–S131

    PubMed  Google Scholar 

  39. Gökbuget N, Hoelzer D (2006) Treatment of adult acute lymphoblastic leukemia. Hematology Am Soc Hematol Educ Program 1:133–141

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Medical Department II, Johann Wolfgang Goethe-University, Frankfurt, Germany

    Nicola Gökbuget, Renate Arnold, Angelika Böhme, Rainer Fietkau, Matthias Freund, Arnold Ganser, Michael Kneba, Thomas Lipp, Wolf-Dieter Ludwig, Georg Maschmeyer, Dorle Messerer, Harald Rieder, Eckhard Thiel & Dieter Hoelzer

Authors
  1. Nicola Gökbuget
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Renate Arnold
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angelika Böhme
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rainer Fietkau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthias Freund
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Arnold Ganser
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael Kneba
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Thomas Lipp
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wolf-Dieter Ludwig
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Georg Maschmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Dorle Messerer
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Harald Rieder
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Eckhard Thiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Dieter Hoelzer
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

German Multicenter Study Group for Adult ALL (GMALL)

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer Berlin Heidelberg

About this chapter

Cite this chapter

Gökbuget, N. et al. (2008). Treatment of Adult ALL According to Protocols of the German Multicenter Study Group for Adult ALL (GMALL). In: Acute Leukemias. Hematologic Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-72304-2_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-72304-2_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-72302-8

  • Online ISBN: 978-3-540-72304-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation