Portal de Periódicos da CAPES

Comparison of intensive, pediatric-inspired therapy with non-intensive therapy in older adults aged 55–65 years with Philadelphia chromosome-negative acute lymphoblastic leukemia

2018; Elsevier BV; Volume: 68; Linguagem: Inglês

10.1016/j.leukres.2018.03.010

1873-5835

Josep‐María Ribera, Olga García, Cristina Gil, Santiago Mercadal, Irene García‐Cadenas, Pau Montesinos, Pere Barba, Susana Vives, José González‐Campos, Mar Tormo, Jordi Esteve, Aurelio López, María José Moreno, Jordi Ribera, Natalia Alonso, Arancha Bermúdez, María Luz Amigo, Eulàlia Genescà, Daniel Fernández-García, Ferran Vall‐Llovera, Juan Bergua, Ramón Guàrdia, María Carmen Monteserín, Teresa Bernal, María Calbacho, Pilar Martínez Narváez-Cabeza de Vaca, Evarist Feliú,

Chronic Myeloid Leukemia Treatments

The standardization of treatment of older adults with Philadelphia chromosome negative (Ph-) acute lymphoblastic leukemia (ALL) is challenging, especially in the age range of 55-65 years. This study aimed to compare intensive, pediatric-inspired therapy with non-intensive therapy in this population of patients.The outcomes of 67 patients prospectively included in two consecutive pediatric-inspired intensive protocols (ALL-HR03 and ALL-HR11) from the Spanish PETHEMA Group were compared with those from 44 patients included in a contemporary semi-intensive protocol (ALL-OLD07).Baseline patient and ALL characteristics were similar in both groups, except for a younger median age in the intensive group (medians: 58 vs. 62 years). Patients treated intensively had a higher complete remission rate (85% vs. 64%, p = 0.005), a lower cumulative incidence of relapse (39% [95%CI, 25% to 52%] vs. 60% [95%CI, 38% to 77%], p = .003), a similar cumulative incidence of treatment-related mortality (28% [95% CI, 18%, 40%] vs. 21% [95% CI, 10%, 34%]) and superior event-free survival at 2 years (37% [95%CI, 25%-49%) vs. 21% [8%-34%], p = 0.002). On multivariable analysis the type of protocol was the only variable with independent significance for event-free survival (HR [95% CI]: 2 [1.3, 3], p = .002).Compared with less intensive chemotherapy, pediatric-inspired intensive chemotherapy significantly improves the outcome of older adults with Ph-negative ALL in the age range of 55-65 years.