期刊
EUROPEAN JOURNAL OF HAEMATOLOGY
卷 102, 期 1, 页码 79-86出版社
WILEY
DOI: 10.1111/ejh.13178
关键词
acute lymphoblastic leukemia; pediatric-inspired; T-cell ALL
类别
资金
- Generalitat de Catalunya [2017 SGR288 (GRC)]
- CERCA Programme/Generalitat de Catalunya
- Fundacio Internacional Josep Carreras
- la Caixa Foundation
- Fondo de Investigaciones Sanitarias [PI14/01971]
- Instituto de Salud Carlos III [FIS16/01433]
- PERIS 2018-2020 from Generalitat de Catalunya [BDNS357800]
Objective and methods Pediatric-inspired regimens have been adopted by several groups as the treatment strategy for adult patients with acute lymphoblastic leukemia (ALL). Whether subsequent modifications of these protocols have led to an improvement in the outcome of patients is uncertain, especially in T-cell ALL. We analyzed 169 patients with high-risk T-cell ALL included in two consecutive trials of the PETHEMA Group (HR-ALL03 [n = 104] and the more contemporary HR-ALL11 [n = 65]). Results Patients and disease characteristics were balanced between both groups. Regarding efficacy, we observed a similar complete remission (CR) rate, relapse and disease-free survival (DFS) between both protocols. Patients included in the HR-ALL11 trial had better 2-year overall survival (OS) compared with the HR-ALL03 (65% [95% CI 51%-79%] vs 44% [95% CI 34%-54%], P = 0.026). Regarding toxicity, we observed a better safety profile in the HR-11 protocol. Irrespective of the protocol, patients with good measurable residual disease (MRD) clearance had a promising outcome without allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CR1, with 2-year OS of 67%. Conclusion Patients with T-cell ALL included in the HR-11 trial showed better OS than patients in the HR-03, mostly driven by a reduction of NRM.
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