title: [Results of the treatment of adult acute lymphoblastic leukemia according to ALL-2005 protocol as a basis for new trials].
abstract: OBJECTIVE
  To analyse the results of the treatment according to ALL-2005 protocol for adult patients with acute lymphoblastic leukemia (ALL); on the basis of the summarized evidence on ALL treatment to propose principles for development of a new program of ALL treatment in 15-55-year-old patients.
  
  
  METHODS
  Five hematological centers (in Moscow, Saransk, Volgograd, Tambov, Kirov) participated in ALL-2005 protocol trial initiated in 2005. A total of 71 adult patients with ALL (age median 27 years) were treated. The results of the MB-2002 study with participation of 16 patients aged 16-23 years performed in the State Hematological Research Center (SHRC) were reviewed
  
  
  RESULTS
  The results of the induction therapy according to ALL-2005 protocol conducted in Moscow SHRC were good: a complete remission was achieved in 90% patients, early lethality was 6%, resistance was observed in 4%. In regional centers lethality in remission was higher, 5-year overall survival was 28% (in SHRC it was 56%), recurrence-free survival in regional center was 22% versus 51%, respectively. Long-term response by ALL-2005 and MB-2002 in patients aged 19-23 was the same, but toxicity of ALL-2005 treatment was higher (no lethality and 5, 4% in induction and remission, respectively).
  
  
  CONCLUSIONS
  The decision was made on design of a new protocol of treatment of Ph-negative ALL for patients aged from 15 to 55 years the main principles of which are the following: continuous treatment with modification of cytostatic drugs doses depending on myelosuppression severity; assessment of tumor cells sensitivity to prednisolone and its replacement for dexametasone throughout the treatment; prolongation of L-asparaginase treatment with elevation of its total dose; monitoring of minimal residual disease (MRD) for decision on late intensification in patients with MRD at late treatment stages (5 months).
authors.forename: E N
authors.initials: EN
authors.lastname: Parovichnikova
authors.forename: Iu R
authors.initials: IuR
authors.lastname: Davidian
authors.forename: V G
authors.initials: VG
authors.lastname: Isaev
authors.forename: A N
authors.initials: AN
authors.lastname: Sokolov
authors.forename: G A
authors.initials: GA
authors.lastname: Kliasova
authors.forename: L P
authors.initials: LP
authors.lastname: Mendeleeva
authors.forename: L S
authors.initials: LS
authors.lastname: Liubimova
authors.forename: E N
authors.initials: EN
authors.lastname: Ustinova
authors.forename: E O
authors.initials: EO
authors.lastname: Gribanova
authors.forename: E S
authors.initials: ES
authors.lastname: Mavrina
authors.forename: S M
authors.initials: SM
authors.lastname: Kulikov
authors.forename: K D
authors.initials: KD
authors.lastname: Kaplanov
authors.forename: T P
authors.initials: TP
authors.lastname: Zagoskina
authors.forename: E I
authors.initials: EI
authors.lastname: Sviridova
authors.forename: L V
authors.initials: LV
authors.lastname: Gavrilova
authors.forename: V G
authors.initials: VG
authors.lastname: Savchenko
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000601:surgery; D055815:Young Adult