title: Role of Chemotherapy and Allografting in the Treatment of Acute Lymphoblastic Leukemia.
abstract: We report the clinical outcomes of 83 patients with acute lymphoblastic leukemia (median age, 46 years; range, 18-75 years) treated at our institution between 1999 and 2011. Treatment refers to clinical trials open for accrual at the time of diagnosis or to institutional guidelines. Upfront allografting was considered for younger high-risk patients. Seventy-eight of 83 (94%) patients achieved complete remission after induction, although 53% of them eventually relapsed. Forty of 70 patients younger than 61 years underwent allografting. The median follow-up was 7.4 years (range, 0.2-15.0 years). Overall, the 5-year overall survival (OS) and event-free survival (EFS) were 40% and 39%, respectively. In patients undergoing transplantation, OS and EFS at 5 years were both 53%, whereas in a nontransplantation setting, both OS and EFS were 35% at 5 years (P = .044 for both OS and EFS). By multivariate analysis, the independent predictors of OS and EFS were age and leukocytosis in the overall population and allografting in young patients.
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy; Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Università di Torino, Scuola di Medicina, Torino, Italy. Electronic address: luisa.giaccone@unito.it.
authors.forename: Luisa
authors.initials: L
authors.lastname: Giaccone
authors.affiliation: Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Ernesta
authors.initials: E
authors.lastname: Audisio
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy; Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Università di Torino, Scuola di Medicina, Torino, Italy.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Bruno
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Maffini
authors.affiliation: Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: D'Ardia
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Caracciolo
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Ferrando
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Butera
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Brunello
authors.affiliation: Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Frairia
authors.affiliation: Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Semra
authors.initials: S
authors.lastname: Aydin
authors.affiliation: Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Nicolino
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Moreno
authors.initials: M
authors.lastname: Festuccia
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Crisà
authors.affiliation: Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Università di Torino, Scuola di Medicina, Torino, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bruna
authors.affiliation: Divisione di Medicina Nucleare 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Passera
authors.affiliation: Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.affiliation: Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Vitolo
authors.affiliation: Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Busca
authors.affiliation: Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Falda
authors.affiliation: Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Marmont
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000628:therapy*; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000379:methods; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Allogeneic stem cell transplantation; Leukocytosis; Targeted therapies; Tyrosine kinase inhibitors