title: Time to post-remission therapy is an independent prognostic factor in adults with acute lymphoblastic leukemia.
abstract: We evaluated patients with newly diagnosed ALL treated at the Cleveland Clinic during the years 1996 through 2005. Cox proportional hazards analysis was used to identify univariate and multivariate correlates of complete remission, overall survival and progression-free survival. On univariate analysis, significant prognostic factors included: age at diagnosis (per 10-year increase), poor risk cytogenetics, time to white blood count recovery, and time from induction chemotherapy (IC) to post-remission therapy (PRT). In patients age <60 years without poor risk cytogenetics, time from IC to PRT (per week increase) was a significant prognostic factor by multivariate analysis and was associated with a decreased progression-free survival [HR 1.27, CI (1.04-1.55), p = 0.019] and decreased overall survival [HR 1.34, CI (1.08-1.67), p = 0.009]. Delayed time from IC to PRT (> or =6.6 weeks) was associated with a statistically worse progression-free and overall survival.
authors.affiliation: Leukemia Program, Department of Hematologic Oncology and Blood Disorders, Taussig Cancer Center, The Cleveland Clinic, Cleveland, OH 44195, USA. advania@ccf.org
authors.forename: Anjali S
authors.initials: AS
authors.lastname: Advani
authors.forename: Tao
authors.initials: T
authors.lastname: Jin
authors.forename: Giridharan
authors.initials: G
authors.lastname: Ramsingh
authors.forename: Ramon
authors.initials: R
authors.lastname: Tiu
authors.forename: Wael
authors.initials: W
authors.lastname: Saber
authors.forename: Karl
authors.initials: K
authors.lastname: Theil
authors.forename: Ronald
authors.initials: R
authors.lastname: Sobecks
authors.forename: Mikkael
authors.initials: M
authors.lastname: Sekeres
authors.forename: Ed
authors.initials: E
authors.lastname: Copelan
authors.forename: Shawnda
authors.initials: S
authors.lastname: Sungren
authors.forename: Barbara
authors.initials: B
authors.lastname: Tripp
authors.forename: Matt
authors.initials: M
authors.lastname: Kalaycio