title: International reference analysis of outcomes in adults with B-precursor Ph-negative relapsed/refractory acute lymphoblastic leukemia.
abstract: Adults with relapsed/refractory acute lymphoblastic leukemia have an unfavourable prognosis, which is influenced by disease and patient characteristics. To further evaluate these characteristics, a retrospective analysis of 1,706 adult patients with Ph-negative relapsed/refractory B-precursor acute lymphoblastic leukemia diagnosed between 1990-2013 was conducted using data reflecting the standard of care from 11 study groups and large centers in Europe and the United States. Outcomes included complete remission, overall survival, and realization of stem cell transplantation after salvage treatment. The overall complete remission rate after first salvage was 40%, ranging from 35%-41% across disease status categories (primary refractory, relapsed with or without prior transplant), and was lower after second (21%) and third or greater (11%) salvage. The overall complete remission rate was higher for patients diagnosed from 2005 onward (45%, 95% CI: 39%-50%). One- and three-year survival rates after first, second, and third or greater salvage were 26% and 11%, 18% and 6%, and 15% and 4%, respectively, and rates were 2%-5% higher among patients diagnosed from 2005. Prognostic factors included younger age, longer duration of first remission, and lower white blood cell counts at primary diagnosis. This large dataset can provide detailed reference outcomes for patients with relapsed/refractory Ph-negative B-precursor acute lymphoblastic leukemia. clinicaltrials.gov identifier: 02003612.
authors: University Hospital, Goethe University, Frankfurt, Germany goekbuget@em.uni-frankfurt.de.
authors: Nicola
authors: N
authors: Gökbuget
authors: Hôpital Saint-Louis, Paris, France.
authors: Hervè
authors: H
authors: Dombret
authors: ICO-Hospital Germans Trias I Pujol, Jose Carreras Research Institute, Barcelona, Spain.
authors: Jose-Maria
authors: JM
authors: Ribera
authors: UCL Cancer Institute, London, UK.
authors: Adele K
authors: AK
authors: Fielding
authors: Cleveland Clinic, Ohio, USA.
authors: Anjali
authors: A
authors: Advani
authors: UOC Ematologia, Ospedale dell'Angelo, Mestre-Venezia, Italy.
authors: Renato
authors: R
authors: Bassan
authors: Center for Observational Research, Amgen, USA.
authors: Victoria
authors: V
authors: Chia
authors: University Hospital, Brno, Czech Republic.
authors: Michael
authors: M
authors: Doubek
authors: Maria Sklodowska Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.
authors: Sebastian
authors: S
authors: Giebel
authors: University Hospital, Goethe University, Frankfurt, Germany.
authors: Dieter
authors: D
authors: Hoelzer
authors: Center Hospitalier Universitaire, Angers, France.
authors: Norbert
authors: N
authors: Ifrah
authors: Center for Observational Research, Amgen, USA.
authors: Aaron
authors: A
authors: Katz
authors: Center for Observational Research, Amgen, USA.
authors: Michael
authors: M
authors: Kelsh
authors: Policlinico Sant'Orsola, Istituto Seragnoli, Bologna, Italy.
authors: Giovanni
authors: G
authors: Martinelli
authors: ICO-Hospital Germans Trias I Pujol, Jose Carreras Research Institute, Barcelona, Spain.
authors: Mireia
authors: M
authors: Morgades
authors: University of Texas, MD Anderson Cancer Center, Houston, USA.
authors: Susan
authors: S
authors: O'Brien
authors: Rambam Medical Center, Haifa, Israel.
authors: Jacob M
authors: JM
authors: Rowe
authors: Clinical Development, Amgen, Germany.
authors: Julia
authors: J
authors: Stieglmaier
authors: Dana Farber Cancer Institute, Boston, Massachusetts, USA.
authors: Martha
authors: M
authors: Wadleigh
authors: University of Texas, MD Anderson Cancer Center, Houston, USA.
authors: Hagop
authors: H
authors: Kantarjian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D019233:Retreatment; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult