title: [Efficiency of treatment of adult patients with acute T-lymphoblastic leukemia according to the ALL-2009 protocol of the Russian Acute Leukemia Study Group].
abstract: OBJECTIVE
  To present the results of treatment in adult patients with acute T-lymphoblastic leukemia (T-ALL) according to the ALL-2009 protocol of the Russian Acute Leukemia Study Group, the basic principle of which is continuation of cytostatic treatment, early switch from prednisolone to dexamethasone, and long-term use of L-asparaginase.
  
  
  METHODS
  The results of diagnosis and treatment were analyzed in 70 patients with different immunological variants of T-ALL treated in the Russian multicenter trial.
  
  
  RESULTS
  Out of the 70 patients with T-ALL, its early immunotype was determined in 32 (45.7%) cases, the thymic and mature immunotypes were found in 31 (44.3%) and 7 (10%) cases, respectively. The median age of the patients with T-ALL was 28 (ranged from 15 to 54) years; men were twice more than women (48 and 22, respectively). Bone marrow lesion was noted in all the patients with early T-ALL and in 80% of the patients with thymic and mature T-ALL. The enlarged mediastinum was significantly more frequently detected in mature T-ALL (100%) than in its early (53.4%) and thymic (60.7%) variants. Therapeutic effectiveness was evaluated in 58 patients. An analysis was made in January 2013. Induction therapy resulted in complete remission in 49 (84.5%) patients. The refractory course of the disease was recorded in 5 (8.6%) cases; early death was in 4 (6.9%). The rate of complete remission in thymic T-ALL, unlike in the early (72%) and mature (71.4%) variants, was significantly higher (100%) due to the absence of resistant forms and early mortality. Moreover, it should be noted that only the patients with early T-ALL (16%) died during the induction phase. In the patients with different variants of T-ALL, the overall and relapse-free survival rates were not significantly different, accounting for 67.2 and 76.2%, respectively. Multivariate analysis revealed no prognostically unfavorable factors that determined long-term results.
  
  
  CONCLUSIONS
  The ALL-2009 protocol is reproducible in any regions of the Russian Federation and highly efficient in treating patients with T-ALL.
authors.forename: E N
authors.initials: EN
authors.lastname: Parovichnikova
authors.forename: G A
authors.initials: GA
authors.lastname: Kliasova
authors.forename: V V
authors.initials: VV
authors.lastname: Troitskaia
authors.forename: A N
authors.initials: AN
authors.lastname: Sokolov
authors.forename: L A
authors.initials: LA
authors.lastname: Kuz'mina
authors.forename: V P
authors.initials: VP
authors.lastname: Mendeleeva
authors.forename: S K
authors.initials: SK
authors.lastname: Kravchenko
authors.forename: V V
authors.initials: VV
authors.lastname: Ryzhko
authors.forename: S N
authors.initials: SN
authors.lastname: Bondarenko
authors.forename: E A
authors.initials: EA
authors.lastname: Kariakina
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000494:pharmacology*; D001216:Asparagine / Q000008:administration & dosage; D001853:Bone Marrow / Q000473:pathology; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000473:pathology; D008875:Middle Aged; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000145:classification / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D011239:Prednisolone / Q000008:administration & dosage; D011379:Prognosis; D012074:Remission Induction; D012426:Russia; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D001216:Asparagine; D003907:Dexamethasone; D011239:Prednisolone