Outcomes of adult acute lymphoblastic leukemia in the era of pediatric-inspired regimens: a single-center experience

Abstract

© 2019, Japanese Society of Hematology. Recent data on acute lymphoblastic leukemia (ALL) treatment with multi-agent chemotherapy showed excellent response in pediatric patients in terms of long-term survival; however, the clinical needs for adult patients are still unmet. Adolescent and young adults’ (AYA) ALL could benefit from a pediatric-inspired regimen with a higher rate of long-term remission. This retrospective study sought to investigate the efficacy of treatment of adult ALL in a single center over the past decade. We analyzed 107 ALL patients with a median age of 26 years (range 15–63 years). Of these, 67.3% received adult regimen and 32.7% received pediatric-inspired regimen. The median follow-up time was 11.6 months (range 1–120). Complete remission (CR) was similarly achieved in over 80% in both schemes. Relapse and refractory rates were higher in the adult group (75%) than in the pediatric (45.7%) group. Two-year disease-free survival in the pediatric group was significantly superior to the adult group (47.1% vs 24.7%, hazard ratio [HR], 1.73, 95% CI 1.22–3.03). Two-year overall survival was higher in pediatric group as compared to adult group (50.8% versus 31.2%, HR 1.52, 95% CI 0.83–2.78). Thus, these findings show that the pediatric-inspired regimen should be considered for the treatment of adult ALL.