Haematologica (Apr 2010)

Outcome after relapse of acute lymphoblastic leukemia in adult patients included in four consecutive risk-adapted trials by the PETHEMA Study Group

  • Albert Oriol,
  • Susana Vives,
  • Jesús-María Hernández-Rivas,
  • Mar Tormo,
  • Inmaculada Heras,
  • Concepción Rivas,
  • Concepción Bethencourt,
  • Federico Moscardó,
  • Javier Bueno,
  • Carlos Grande,
  • Eloy del Potro,
  • Ramon Guardia,
  • Salut Brunet,
  • Juan Bergua,
  • Teresa Bernal,
  • Maria-José Moreno,
  • Carlota Calvo,
  • Pilar Bastida,
  • Evarist Feliu,
  • Josep-Maria Ribera

DOI
https://doi.org/10.3324/haematol.2009.014274
Journal volume & issue
Vol. 95, no. 4

Abstract

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Background About one half of adults with acute lymphoblastic leukemia are not cured of the disease and ultimately die. The objective of this study was to explore the factors influencing the outcome of adult patients with relapsed acute lymphoblastic leukemia.Design and Methods We analyzed the characteristics, the outcome and the prognostic factors for survival after first relapse in a series of 263 adult patients with acute lymphoblastic leukemia (excluding those with mature B-cell acute lymphoblastic leukemia) prospectively enrolled in four consecutive risk-adapted PETHEMA trials.Results The median overall survival after relapse was 4.5 months (95% CI, 4–5 months) with a 5-year overall survival of 10% (95% CI, 8%–12%); 45% of patients receiving intensive second-line treatment achieved a second complete remission and 22% (95% CI, 14%–30%) of them remained disease free at 5 years. Factors predicting a good outcome after rescue therapy were age less than 30 years (2-year overall survival of 21% versus 10% for those over 30 years old; P