title: Long-term outcome of a pediatric-inspired regimen used for adults aged 18-50 years with newly diagnosed acute lymphoblastic leukemia.
abstract: On the basis of the data suggesting that adolescents and young adult patients with acute lymphoblastic leukemia (ALL) have improved outcomes when treated on pediatric protocols, we assessed the feasibility of treating adult patients aged 18-50 years with ALL with the DFCI Pediatric ALL Consortium regimen utilizing a 30-week course of pharmacokinetically dose-adjusted E. coli L-asparaginase during consolidation. Between 2002 and 2008, 92 eligible patients aged 18-50 years were enrolled at 13 participating centers. Seventy-eight patients (85%) achieved a complete remission (CR) after 1 month of intensive induction therapy. With a median follow-up of 4.5 years, the 4-year disease-free survival (DFS) for the patients achieving a CR was 69% (95% confidence interval (CI) 56-78%) and the 4-year overall survival (OS) for all eligible patients was 67% (95% CI 56-76%). The 4-year DFS for the 64 patients who achieved a CR and were Philadelphia chromosome negative (Ph-) was 71% (95% CI 58-81%), and for all 74 Ph- patients the 4-year OS was 70% (95% CI 58-79%). We conclude that a pediatric-like treatment strategy for young adults with de novo ALL is feasible, associated with tolerable toxicity, and results in improved outcomes compared with historical regimens in young adult patients with ALL.
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors: D J
authors: DJ
authors: DeAngelo
authors: Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors: K E
authors: KE
authors: Stevenson
authors: Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors: S E
authors: SE
authors: Dahlberg
authors: Department of Pediatric Oncology, Dana-Farber Cancer Institute/Division of Pediatric Hematology-Oncology, Boston Children's Hospital, Boston, MA, USA.
authors: L B
authors: LB
authors: Silverman
authors: 1] National Cancer Institute of Canada Clinical Trials Group, Kingston, Ontario, Canada [2] Dalhousie University, Halifax, Nova Scotia, Canada.
authors: S
authors: S
authors: Couban
authors: Massachusetts General Hospital, Boston, MA, USA.
authors: J G
authors: JG
authors: Supko
authors: Massachusetts General Hospital, Boston, MA, USA.
authors: P C
authors: PC
authors: Amrein
authors: Massachusetts General Hospital, Boston, MA, USA.
authors: K K
authors: KK
authors: Ballen
authors: Cancer Care Manitoba, Winnipeg, Manitoba, Canada.
authors: M D
authors: MD
authors: Seftel
authors: Cross Cancer Institute, Edmonton, Alberta, Canada.
authors: A R
authors: AR
authors: Turner
authors: Hamilton Health Sciences Center, Hamilton, Ontario, Canada.
authors: B
authors: B
authors: Leber
authors: London Health Services, London, Ontario, Canada.
authors: K
authors: K
authors: Howson-Jan
authors: Columbia University Medical Center, New York, NY, USA.
authors: K
authors: K
authors: Kelly
authors: Hospital Maisonneuve-Rosemont, Montreal, Quebec, Canada.
authors: S
authors: S
authors: Cohen
authors: Queen's University, Kingston, Ontario, Canada.
authors: J H
authors: JH
authors: Matthews
authors: Tom Baker Cancer Center, Calgary, Alberta, Canada.
authors: L
authors: L
authors: Savoie
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors: M
authors: M
authors: Wadleigh
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors: L A
authors: LA
authors: Sirulnik
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors: I
authors: I
authors: Galinsky
authors: Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors: D S
authors: DS
authors: Neuberg
authors: Department of Pediatric Oncology, Dana-Farber Cancer Institute/Division of Pediatric Hematology-Oncology, Boston Children's Hospital, Boston, MA, USA.
authors: S E
authors: SE
authors: Sallan
authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors: R M
authors: RM
authors: Stone
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D001215:Asparaginase / Q000008:administration & dosage*; D003561:Cytarabine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007621:Karyotyping; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D057285:Precision Medicine; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D014750:Vincristine; D004317:Doxorubicin; D001215:Asparaginase; D011241:Prednisone; D008727:Methotrexate