Young adults with ALL have survival gain with pediatric regimen
Using a pediatric chemotherapy regimen to treat young adults with acute lymphoblastic leukemia (ALL) significantly improved their outcomes compared to what has historically been achieved with “adult” treatment protocols, report Dana-Farber Cancer Institute scientists.
Overall survival and disease-free survival at three years exceeded 70 percent in patients between 18 and 50 years old, according to results of a multi-center phase 2 trial presented at the 57th American Society of Hematology (ASH) Annual Meeting and Exposition in Orlando.
“This is better than the 40 percent historically seen in this patient group,” said Richard Stone, MD, senior author of the study abstract, who added that the median survival rate had not yet been reached. Daniel DeAngelo, MD, PhD, of Dana-Farber is the first author and leader of the study. This was a single-arm trial with no control group.
ALL is most common in early childhood and most can be successfully treated with chemotherapy. About 1,000 new cases are diagnosed annually in adults, who have a poorer prognosis; most of the deaths from ALL occur in older patients.
DeAngelo and others at Dana-Farber and elsewhere have observed that young adults treated by pediatric oncologists for ALL fared better than those who underwent standard adult regimens, which include more drugs that suppress bone marrow function. As a result, pediatric regimens have been tried in young adult patients, yielding improved outcomes, said Stone. “I’ve put many patients on this regimen, and they have been doing very well.”