Outcome of relapsed adult lymphoblastic leukemia depends on response to salvage chemotherapy, prognostic factors, and performance of stem cell transplantation

Goekbuget, Nicola and Stanze, Daniel and Beck, Joachim and Diedrich, Helmut and Horst, Heinz-August and Huettmann, Andreas and Kobbe, Guido and Kreuzer, Karl-Anton and Leimer, Lothar and Reichle, Albrecht and Schaich, Markus and Schwartz, Stefan and Serve, Hubert and Starck, Michael and Stelljes, Matthias and Stuhlmann, Reingard and Viardot, Andreas and Wendelin, Knut and Freund, Mathias and Hoelzer, Dieter (2012) Outcome of relapsed adult lymphoblastic leukemia depends on response to salvage chemotherapy, prognostic factors, and performance of stem cell transplantation. BLOOD, 120 (10). pp. 2032-2041. ISSN 0006-4971,

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Abstract

Despite improvements in first-line therapies, published results on the treatment of relapsed adult acute lymphoblastic leukemia (ALL) show that prognosis is still poor. The aim of the present retrospective analysis of the German Multicenter Study Group for Adult ALL was to identify prognostic factors and options for improvement. A total of 547 patients with a median age of 33 years (range, 15-55) experiencing their first relapse (406 vs 141 shorter or longer than 18 months from diagnosis) were evaluated. The aim of salvage therapy was to achieve a complete remission (CR) with subsequent a stem cell transplantation (SCT). The CR rate (assessed in Philadelphia chromosome- and BCR-ABL-negative ALL without CNS involvement) after the first salvage in relapse after chemotherapy (n = 224) was 42%. After failure of first salvage (n = 82), the CR rate after second salvage was 33%. In relapse after SCT (n = 48) the CR rate after first salvage was 23%. The median overall survival after relapse was 8.4 months and survival was 24% at 3 years. Prognostic factors for survival were relapse localization, response to salvage, performance of SCT, and age. Overall survival appeared superior compared with previously published studies, likely because of the high rate of SCT in the present study (75%). Further improvement may be achieved with earlier relapse detection and experimental approaches in early relapse. The study is registered at www.clinicaltrials.gov as NCT00199056 and NCT00198991. (Blood. 2012; 120(10):2032-2041)

Item Type: Article
Uncontrolled Keywords: ACUTE LYMPHOCYTIC-LEUKEMIA; STANDARD-RISK; PHASE-II; NELARABINE; THERAPY; DISEASE; TRIALS;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie)
Depositing User: Dr. Gernot Deinzer
Date Deposited: 06 May 2020 06:46
Last Modified: 06 May 2020 06:46
URI: https://pred.uni-regensburg.de/id/eprint/18125

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