Leukemia Research Reports (Jan 2021)

Improved survival in adolescents and young adults (AYA) patients aged 14–55 years with acute lymphoblastic leukemia using pediatric-inspired protocol – a retrospective analysis of a real-world experience in 79 of patients treated at a national tertiary care referral center

  • Amr Hanbali,
  • Ahmed Kotb,
  • Riad El Fakih,
  • Feras Alfraih,
  • Syed Osman Ahmed,
  • Marwan Shaheen,
  • Saud Alhayli,
  • Ali Alahmari,
  • Ahmad Alotaibi,
  • Alfadel Alshaibani,
  • Mahmoud Abu Riash,
  • Farah Deeba,
  • Maryam Asif,
  • Walid Rasheed,
  • Hazzaa Alzahrani,
  • Fahad Alsharif,
  • Naeem Chaudhri,
  • Fahad Almohareb,
  • Mahmoud Aljurf

Journal volume & issue
Vol. 16
p. 100270

Abstract

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Background: Treating adolescents and young adults (AYA) patients with acute lymphoblastic leukemia (ALL) using pediatric-inspired protocols have shown improvement in outcomes. Most data available in the literature of such protocols is derived from well-controlled clinical trials. This report aims to provide a real-world experience from using a pediatric-inspired protocol in ALL-AYA population in larger number of patients treated at a national tertiary care referral center. Methods: Newly diagnosed Philadelphia negative ALL-AYA patients ages between 14 and 55 years of age were treated on an institutional protocol (AYA-15 protocol) adopted from a modified version of Children's Cancer Group (CCG) 1900 protocol. At the time of this publication, a total of 79 patients were treated using the AYA-15 protocol between 2015 and 2020). Event-free survival (FFS), disease-free survival (DFS), and overall survival (OS) were analyzed using cumulative incidence and Kaplan-Meier methods. Results: The median age at diagnosis was 18 years (14–51 years) with 63% male patients. Complete remission (CR) at day 28 of induction was achieved in 88.6% of which 73.4% were minimal residual disease (MRD) negative. At a median follow up of 5 years, EFS, DFS and OS were 57.5%, 69.2% and 75.8% respectively. Toxicities were within the expected range with infections and transaminitis being the most common adverse events. Conclusion: Our single-center experience real-world data in treating AYA-ALL patients with pediatric-inspired protocol demonstrates encouraging results of high survival rate and excellent tolerability for patients aged 18–55 years.

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