Comparison of a pediatric-inspired treatment protocol versus standard-intensity chemotherapy for young adults with standard-risk BCR-ABL negative acute lymphoblastic leukemia

Abstract

We investigated the utility of a pediatric-inspired protocol in adults aged 18–40 years with standard-risk BCR-ABL negative acute lymphoblastic leukemia (ALL). Retrospective outcomes of 25 patients treated with a pediatric protocol between 2008 and 2014 were compared with 22 similarly aged patients treated with an adult protocol between 2003 and 2008. Twenty-five (100%) and 19 (86%) patients achieved complete remission, respectively. At median follow-up of 36.8 months, 3-year event-free survival was increased in patients on the pediatric protocol at 80% versus 45% (p = .019). There was a trend toward improved overall survival at 80% versus 59% (p = .12). Treatment-related toxicity was not increased despite the increased treatment intensity. Patients with BCR and/or ABL copy number variation demonstrated comparatively poorer outcomes in both cohorts. In our experience with this cohort of patients, pediatric-based protocols are safe and effective, justifying their use in younger adults with ALL.

Keywords:

• Acute lymphoblastic leukemia
• chemotherapy
• adolescent
• adult
• asparaginase

Acknowledgements

We thank Janet Nitta for data collection and statistical analysis. We acknowledge the contribution of the medical and nursing staff of Leukemia/BMT Program of BC at Vancouver General Hospital and BC Cancer Agency and to the nurses of The Hematology Research Unit for their support and follow up on patients.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at http://dx.doi.org/10.1080/10428194.2016.1222376.