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High relapse rate of T cell acute lymphoblastic leukemia in adults treated with Hyper-CVAD chemotherapy in Sweden

In English

Författare

  • Piotr Kozlowski
  • Maria Astrom
  • Lucia Ahlberg
  • Per Bernell
  • Erik Hulegardh
  • Hans Hagglund
  • Karin Karlsson
  • Alicja Markuszewska-Kuczymska
  • Beata Tomaszewska-Toporska
  • Bengt Smedmyr
  • Rose-Marie Amini
  • Helene Hallbook
Visa allt

Summary, in English

Background Hyper-CVAD is widely used to treat acute lymphoblastic leukemia (ALL) and aggressive lymphomas. This multicenter, population-based study assessed the efficacy of Hyper-CVAD as first-line therapy in patients with T-cell ALL (T-ALL). Patients and methods Between October 2002 and September 2006, 24 patients were diagnosed with T-ALL in Sweden; 19 were eligible for treatment with the protocol. Results The median age was 32yr (range 18-72yr). Complete remission (CR) was obtained in 17 of 19 (89%) patients, and the treatment was relatively well tolerated. Allogeneic stem cell transplantation (SCT) was recommended in high-risk disease and was performed in four patients upfront. Two- and 5-yr leukemia-free survivals (LFS) in 17 patients with CR achievement were identical, at 29% (95% confidence interval [CI]: 8-51). Two- and 5-yr overall survival (OS) in whole cohort was 63% (95% CI: 42-85) and 47% (95% CI: 26-69), respectively. The 5-yr LFS for 15 patients who did not receive allogeneic SCT upfront were 20% (95% CI: 0-40), although 14 of 15 completed the protocol (eight cycles). Relapse occurred in 2 of 4 upfront-transplanted patients and in 12 of 15 patients treated with chemotherapy alone, six of whom received allogeneic SCT in CR2. Age >= 35yr influenced OS negatively in univariate analysis (HR 5.1, 95% CI: 1.55-16.7). Conclusions Hyper-CVAD treatment resulted in a high CR rate and appeared safe, but it showed poor efficacy at preventing relapse. Therefore, this treatment is no longer recommended for adults with T-ALL in Sweden.

Publiceringsår

2014

Språk

Engelska

Sidor

377-381

Publikation/Tidskrift/Serie

European Journal of Haematology

Volym

92

Issue

5

Dokumenttyp

Artikel i tidskrift

Förlag

Wiley-Blackwell

Ämne

  • Hematology

Nyckelord

  • antineoplastic combined chemotherapy protocols
  • treatment outcome
  • precursor T-cell lymphoblastic leukemia-lymphoma
  • stem cell
  • transplantation

Status

Published

ISBN/ISSN/Övrigt

  • ISSN: 1600-0609