期刊
BLOOD
卷 114, 期 25, 页码 5136-5145出版社
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2009-08-231217
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资金
- National Institutes of Health [R01CA120196]
- WOLF Foundation
- Leukemia & Lymphoma Society [1287-08, 6237-08]
- Leukaemia Research United Kingdom
- Medical Research Council [G8223452]
- Medical Research Council [G0500389, G8223452, MC_U137686856] Funding Source: researchfish
- MRC [G0500389, G8223452, MC_U137686856] Funding Source: UKRI
The biology and outcome of adult T-cell acute lymphoblastic leukemia are poorly understood. We present here the clinical and biologic features of 356 patients treated uniformly on the prospective trial (UKALL XII/ECOG 2993) with the aim of describing the outcome and identifying prognostic factors. Complete remission was obtained in 94% of patients, and 48% survived 5 years. Positivity of blasts for CD1a and lack of expression of CD13 were associated with better survival (P = .01 and < .001, respectively). NOTCH1 and CDKN2A mutations were seen in 61% and 42% of those tested. Complex cytogenetic abnormalities were associated with poorer survival (19% vs 51% at 5 years, P = .006). Central nervous system involvement at diagnosis did not affect survival (47% vs 48%, P = not significant). For 99 patients randomized between autograft and chemotherapy, 5-year survival was 51% in each arm. Patients with a matched sibling donor had superior 5-year survival to those without donors (61% vs 46%, chi(2), P = .02); this was the result of less relapse (25% vs 51% at 5 years, P < .001). Only 8 of 123 relapsed patients survive. This study provides a baseline for trials of new drugs, such as nelarabine, and may allow risk-adapted therapy in patients with poor-prognosis T-cell ALL. (Blood. 2009; 114: 5136-5145)
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