TY - JOUR
T1 - A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia
T2 - Results of CALGB 10403
AU - Stock, Wendy
AU - Luger, Selina M.
AU - Advani, Anjali S.
AU - Yin, Jun
AU - Harvey, Richard C.
AU - Mullighan, Charles G.
AU - Willman, Cheryl L.
AU - Fulton, Noreen
AU - Laumann, Kristina M.
AU - Malnassy, Greg
AU - Paietta, Elisabeth
AU - Parker, Edy
AU - Geyer, Susan
AU - Mrózek, Krzysztof
AU - Bloomfield, Clara D.
AU - Sanford, Ben
AU - Marcucci, Guido
AU - Liedtke, Michaela
AU - Claxton, David F.
AU - Foster, Matthew C.
AU - Bogart, Jeffrey A.
AU - Grecula, John C.
AU - Appelbaum, Frederick R.
AU - Erba, Harry
AU - Litzow, Mark R.
AU - Tallman, Martin S.
AU - Stone, Richard M.
AU - Larson, Richard A.
N1 - Funding Information:
This work was supported by the National Cancer Institute of the National Institutes of Health under awards U10CA180821 and U10CA180882 (to the Alliance for Clinical Trials in Oncology), P30CA033572, U10CA180790, U10CA180791, U10CA180820, U10CA180836, U10CA180838, U10CA180850, U10CA180867, U10CA180888, and U10CA189859 and in part by funds from Leadiant Biosciences, Inc.
Publisher Copyright:
© 2019 by The American Society of Hematology.
PY - 2019/4/4
Y1 - 2019/4/4
N2 - Retrospective studies have suggested that older adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL) have better survival rates when treated using a pediatric ALL regimen administered by pediatric treatment teams. To address the feasibility and efficacy of using a pediatric treatment regimen for AYA patients with newly diagnosed ALL administered by adult treatment teams, we performed a prospective study, CALGB 10403, with doses and schedule identical to those in the Children’s Oncology Group study AALL0232. From 2007 to 2012, 318 patients were enrolled; 295 were eligible and evaluable for response. Median age was 24 years (range, 17-39 years). Use of the pediatric regimen was safe; overall treatment-related mortality was 3%, and there were only 2 postremission deaths. Median event-free survival (EFS) was 78.1 months (95% confidence interval [CI], 41.8 to not reached), more than double the historical control of 30 months (95% CI, 22-38 months); 3-year EFS was 59% (95% CI, 54%-65%). Median overall survival (OS) was not reached. Estimated 3-year OS was 73% (95% CI, 68%-78%). Pretreatment risk factors associated with worse treatment outcomes included obesity and presence of the Philadelphia-like gene expression signature. Use of a pediatric regimen for AYAs with ALL up to age 40 years was feasible and effective, resulting in improved survival rates compared with historical controls. CALGB 10403 can be considered a new treatment standard upon which to build for improving survival for AYAs with ALL.
AB - Retrospective studies have suggested that older adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL) have better survival rates when treated using a pediatric ALL regimen administered by pediatric treatment teams. To address the feasibility and efficacy of using a pediatric treatment regimen for AYA patients with newly diagnosed ALL administered by adult treatment teams, we performed a prospective study, CALGB 10403, with doses and schedule identical to those in the Children’s Oncology Group study AALL0232. From 2007 to 2012, 318 patients were enrolled; 295 were eligible and evaluable for response. Median age was 24 years (range, 17-39 years). Use of the pediatric regimen was safe; overall treatment-related mortality was 3%, and there were only 2 postremission deaths. Median event-free survival (EFS) was 78.1 months (95% confidence interval [CI], 41.8 to not reached), more than double the historical control of 30 months (95% CI, 22-38 months); 3-year EFS was 59% (95% CI, 54%-65%). Median overall survival (OS) was not reached. Estimated 3-year OS was 73% (95% CI, 68%-78%). Pretreatment risk factors associated with worse treatment outcomes included obesity and presence of the Philadelphia-like gene expression signature. Use of a pediatric regimen for AYAs with ALL up to age 40 years was feasible and effective, resulting in improved survival rates compared with historical controls. CALGB 10403 can be considered a new treatment standard upon which to build for improving survival for AYAs with ALL.
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U2 - 10.1182/blood-2018-10-881961
DO - 10.1182/blood-2018-10-881961
M3 - Article
C2 - 30658992
AN - SCOPUS:85063522947
SN - 0006-4971
VL - 133
SP - 1548
EP - 1559
JO - Blood
JF - Blood
IS - 14
ER -
