title: Comparison of the results of the treatment of adolescents and young adults with standard-risk acute lymphoblastic leukemia with the Programa Español de Tratamiento en Hematología pediatric-based protocol ALL-96.
abstract: OBJECTIVE
  Retrospective studies have shown that adolescents and young adults with acute lymphoblastic leukemia (ALL) treated with pediatric protocols have better outcomes than similarly aged patients treated with adult protocols, but prospective studies comparing adolescents and young adults using pediatric schedules are scarce. The ALL-96 protocol was addressed to compare the toxicity and results of a pediatric-based protocol in adolescents (age 15-18 years) and young adults (age 19-30 years) with standard-risk (SR) ALL.
  
  
  METHODS
  Adolescents (n = 35) and young adults (n = 46) received a standard five-drug/5-week induction course followed by two cycles of early consolidation, maintenance with monthly reinforcement cycles up to 1 year in continuous complete remission (CR) and 1 year with standard maintenance chemotherapy up to 2 years in CR.
  
  
  RESULTS
  Adolescents and young adults were comparable in the main pretreatment ALL characteristics. The CR rate was 98% and. after a median follow-up of 4.2 years, 6-year event-free survival (EFS) and overall survival (OS) were 61% (95% CI, 51% to 72%) and 69% (95% CI, 59% to 79%), respectively, with no differences between adolescents and young adults. The hematologic toxicity in consolidation and reinforcement cycles was higher in young adults than in adolescents. Slow response to induction therapy was the only parameter associated with poor EFS (34% v 67%) and OS (40% v 76%).
  
  
  CONCLUSIONS
  The response to the pediatric ALL-96 protocol was identical in adolescents and young adults despite a slight increase in hematologic toxicity observed in adults. This justifies the age-unrestricted use of pediatric regimens to treat patients with SR ALL.
authors.affiliation: Servicio de Hematología Clínica, Institut Català d'Oncologia-Hospital Universitari Germans Trias i Pujol, C/ Canyet S/N, 08916 Badalona, Spain. jribera@iconcologia.net
authors.forename: Josep-María
authors.initials: JM
authors.lastname: Ribera
authors.forename: Albert
authors.initials: A
authors.lastname: Oriol
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Sanz
authors.forename: Mar
authors.initials: M
authors.lastname: Tormo
authors.forename: Pascual
authors.initials: P
authors.lastname: Fernández-Abellán
authors.forename: Eloy
authors.initials: E
authors.lastname: del Potro
authors.forename: Eugenia
authors.initials: E
authors.lastname: Abella
authors.forename: Javier
authors.initials: J
authors.lastname: Bueno
authors.forename: Ricardo
authors.initials: R
authors.lastname: Parody
authors.forename: Pilar
authors.initials: P
authors.lastname: Bastida
authors.forename: Carlos
authors.initials: C
authors.lastname: Grande
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Heras
authors.forename: Concepción
authors.initials: C
authors.lastname: Bethencourt
authors.forename: Evarist
authors.initials: E
authors.lastname: Feliu
authors.forename: Juan-José
authors.initials: JJ
authors.lastname: Ortega
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001215:Asparaginase / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D007223:Infant; D007239:Infections / Q000139:chemically induced; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D014750:Vincristine; D003520:Cyclophosphamide; D001215:Asparaginase; D011241:Prednisone; D006854:Hydrocortisone; D008727:Methotrexate; D003630:Daunorubicin