Improved survival using an intensive, pediatric-based chemotherapy regimen in adults with T-cell acute lymphoblastic leukemia.
All patients with newly diagnosed T-cell acute lymphoblastic leukemia (T-ALL) and treated over a 17-year period at a single institution were retrospectively analyzed. From 1990 to 2000, 40 patients were treated with a variety of adult-based ALL regimens. From 2000 to 2007, a pediatric-based protocol, DFCI (Dana Farber Cancer Institute), was used as the standard regimen for all patients (n = 32). The two groups (DFCI and non-DFCI) had comparable baseline characteristics. Complete response rates were not significantly different between the DFCI- and non-DFCI-treated groups. The 3-year relapse free survival (RFS) and overall survival (OS) were significantly higher in the DFCI-treated group (p < 0.0001 and p = 0.0003, respectively). On multivariate analysis, the treatment group (DFCI vs. non-DFCI) was the major prognostic factor influencing both RFS and OS. The results provide evidence supporting the superior efficacy of asparaginase-intensive pediatric-based regimens for adults with T-ALL.
Al-Khabori
Murtadha
M
Department of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada.
Minden
Mark D
MD
Yee
Karen W L
KW
Gupta
Vikas
V
Schimmer
Aaron D
AD
Schuh
Andre C
AC
Xu
Wei
W
Brandwein
Joseph M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D010372:Pediatrics / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome