A pediatric regimen for adolescents and young adults with Philadelphia chromosome-negative acute lymphoblastic leukemia : Results of the ALLRE08 PETHEMA trial
Ribera, Jose-Maria (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Morgades, Mireia (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Montesinos, Pau (Hospital Universitari i Politècnic La Fe (València))
Tormo, Mar (Hospital Clínic Universitari (València))
Martínez-Carballeira, Daniel (Hospital Universitario Central de Asturias)
González-Campos, José (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Gil, Cristina (Hospital General Universitario de Alicante (Alacant, País Valencià))
Barba, Pere (Hospital Universitari Vall d'Hebron)
García-Boyero, Raimundo (Consorci Hospitalari Provincial de Castelló)
Coll, Rosa (Hospital Universitari de Girona Doctor Josep Trueta)
Pedreño, María (Hospital Universitari Doctor Peset (València))
Ribera Salas, Jordi (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Mercadal, Santiago (Institut Català d'Oncologia)
Vives Polo, Susana (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Novo, Andrés (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Genescà, Eulàlia (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Hernández Rivas, Jesús María (Hospital Universitario de Salamanca)
Bergua Burgues, Juan Miguel (Hospital San Pedro de Alcántara)
Amigo, María-Luz (Hospital General Universitario Morales Meseguer (Múrcia))
Vall-Llovera, Ferran (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Martínez-Sánchez, Pilar (Hospital Universitario 12 de Octubre (Madrid))
Calbacho, Maria (Hospital Universitario Ramón y Cajal (Madrid))
Garcia Cadenas, Irene (Institut d'Investigació Biomèdica Sant Pau)
Garcia-Guiñón, Antoni (Hospital Arnau de Vilanova (Lleida, Catalunya))
Sánchez-Sánchez, María-José (Hospital Universitario Lucus Augusti (Lugo))
Cervera, Marta (Hospital Universitari Joan XXIII de Tarragona)
Feliu Frasnedo, Evarist (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Orfao, Alberto (Hospital Clínico Universitario (Salamanca))
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	Pediatric-based or -inspired trials have improved the prognosis of adolescents and young adults (AYA) with Philadelphia chromosome-negative (Ph-neg) acute lymphoblastic leukemia (ALL). This study reports the results of treatment of the ALLRE08 trial, a full pediatric trial for AYA aged 15-30 years with standard-risk (SR) ALL. From 2008 to 2018, 89 patients (38 adolescents [15-18 years] and 51 young adults [YA, 19-30 years], median age: 20 [15-29] years) were enrolled in the ALLRE08 trial. The complete response (CR) was 95%. Twenty-two patients were transferred to a high-risk (HR) protocol because of poor marrow response on day 14 (n = 20) or high-level of end-induction minimal residual response (MRD ≥ 0. 25%, n = 2). Cumulative incidence of relapse (CIR) at 5 years was 35% (95%CI: 23%-47%), with significant differences between adolescents and YA: 13% (4%-28%) vs 52% (34%-67%), P = . 012. No treatment-related mortality was observed in 66/66 patients following the ALLRE08 trial vs 3/23 patients moved to a HR trial. The estimated 5-year overall survival (OS) was 74% (95%CI: 63%-85%), with significantly higher rates for adolescents vs YA: 87% (95%CI: 74%-100%) vs 63% (46%-80%), P = . 021. Although CIR or OS were lower in patients who were transferred to a HR trial, the differences were not statistically significant (CIR: 34% [21%-47%] vs 37% [14%-61%]; OS: 78% [66%-90%] vs 61% [31%;91%]). A full pediatric trial is feasible and effective for AYA with Ph-neg, SR-ALL, with better results for adolescents than for YA. Outcome of patients with poor early response rescued with a HR trial was not significantly inferior. A full pediatric trial is feasible and effective for adolescent and young adults with acute lymphoblastic leukemia, with better results for adolescents than for young adults. The outcome of patients showing poor early response was not significantly inferior than that observed for good responders after being transferred to a high-risk trial.
Grants:	Instituto de Salud Carlos III PI14-01971 Agència de Gestió d'Ajuts Universitaris i de Recerca SGR288
Note:	Altres ajuts: Supported in part by grants from Fundació La Caixa and CIBERONC (JMHR and AO).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Acute lymphoblastic leukemia ; Adolescents and young adults ; Pediatric treatment
Published in:	Cancer Medicine, Vol. 9 (february 2020) , p. 2317-2329, ISSN 2045-7634

DOI: 10.1002/cam4.2814
PMID: 32022463

13 p, 589.3 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP) > Josep Carreras Leukaemia Research Institute
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles