RT Journal Article
T1 A pediatric regimen for adolescents and young adults with Philadelphia chromosome-negative acute lymphoblastic leukemia: Results of the ALLRE08 PETHEMA trial.
A1 Ribera, Josep-Maria
A1 Morgades, Mireia
A1 Montesinos, Pau
A1 Tormo, Mar
A1 Martínez-Carballeira, Daniel
A1 González-Campos, José
A1 Gil, Cristina
A1 Barba, Pere
A1 García-Boyero, Raimundo
A1 Coll, Rosa
A1 Pedreño, María
A1 Ribera, Jordi
A1 Mercadal, Santiago
A1 Vives, Susana
A1 Novo, Andrés
A1 Genescà, Eulàlia
A1 Hernández-Rivas, Jesús-María
A1 Bergua, Juan
A1 Amigo, María-Luz
A1 Vall-Llovera, Ferran
A1 Martínez-Sánchez, Pilar
A1 Calbacho, María
A1 García-Cadenas, Irene
A1 Garcia-Guiñon, Antoni
A1 Sánchez-Sánchez, María-José
A1 Cervera, Marta
A1 Feliu, Evarist
A1 Orfao, Alberto
A1 PETHEMA Group, Spanish Society of Hematology
K1 acute lymphoblastic leukemia
K1 adolescents and young adults
K1 pediatric treatment
AB 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). 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. 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%]). 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.
YR 2020
FD 2020-02-05
LK http://hdl.handle.net/10668/15048
UL http://hdl.handle.net/10668/15048
LA en
DS RISalud
RD Apr 5, 2025