[Adolescents with de novo acute lymphoblastic leukemia: efficacy and safety of a pediatric vs adult treatment protocol].
OBJECTIVE
To ascertain the efficacy and safety of two chemotherapy regimens, one designed for adults and the other for children, in adolescent patients with acute lymphoblastic leukemia (ALL).


METHODS
Between 2001-2006, we included patients aged 15-25, with de novo, Phi(-) ALL, without initial central nervous system (CNS) infiltration. Twenty patients received a chemotherapy regimen designed for children with high-risk ALL (LALIN) and twenty a regimen for adults (LALA). Both were intensive and included dexamethasone, daunorubicin, cyclophosphamide, vincristine, cytarabine, methotrexate and mercaptopurine as well as CNS prophylaxis. Elective suspension of chemotherapy occurred at two and three years respectively, in patients with continued complete remission.


RESULTS
Patients in both groups were comparable in age, sex, presence and size of hepatosplenomegaly, initial leukocytes and platelet counts. Predominant in both groups was L2 morphology and B-cell CD10(+) immunophenotype. Results for the LALIN/ LALA groups were: failures 2/0 (p=0.49); relapses 0/4 (p= 0.05); therapy associated deaths 4/7 (p= 0.48); and event free survival at 70 months follow-up was 70% and 40% (p=0.12).


CONCLUSIONS
In patients aged 15-25, with de novo ALL, a chemotherapy regimen designed for children had significantly less relapses than a regimen for adults. We saw no increase in toxicity in the LALIN versus the LALA group.
López-Hernández
Manuel Antonio
MA
Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, ISSSTE, México DF, México. lopema@prodigy.net.mx
Alvarado-Ibarra
Martha
M
Jiménez-Alvarado
Rosa María
RM
De Diego-Flores
José Enrique
JE
González-Avante
Crescencio Mauricio
CM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma; D055815:Young Adult