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Risk group assignme...
Risk group assignment differs for children and adults 1-45 years with acute lymphoblastic leukemia treated by the NOPHO ALL-2008 protocol
- Article/chapterEnglish2013
Publisher, publication year, extent ...
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2013-04-02
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Wiley,2013
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Numbers
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LIBRIS-ID:oai:DiVA.org:uu-197741
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-197741URI
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https://doi.org/10.1111/ejh.12097DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:126636998URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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BACKGROUND: The prognosis of acute lymphoblastic leukemia is poorer in adults than in children. Studies have indicated that young adults benefit from pediatric treatment, although no upper age limit has been defined.DESIGN AND METHODS:We analyzed 749 patients aged 1-45 years treated by the NOPHO ALL-2008 protocol. Minimal residual disease (MRD) on days 29 and 79, immunophenotype, white blood cell count (WBC), and cytogenetics were used to stratify patients to standard, intermediate, or high risk treatment with or without hematopoietic stem cell transplantation.RESULTS: Adults aged 18-45 had significantly lower WBCs at diagnosis compared to children aged 1-9 and 10-17 years, but significantly more adults were stratified to high-risk chemotherapy (8%, 14%, 17%; p < 0.0001) or high risk chemotherapy with transplantation (4%, 13%, 19%; p < 0.0001). This age dependent skewing of risk grouping reflected more T-ALL (11%, 27%, 33%, p < 0.0001), poorer MRD response day 29 (MRD < 0.1%: 75%, 61%, 52%; p < 0.0001), and more MLL gene rearrangements (3%, 3%, 10%; p = 0.005) in older patients.CONCLUSIONS:Even if identical diagnostics, treatment, and risk stratification are implemented, more adults will be stratified to high risk therapy, which should be considered when comparing pediatric and adult outcomes.
Added entries (persons, corporate bodies, meetings, titles ...)
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Birgens, Henrik
(author)
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Abrahamsson, Jonas
(author)
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Bernell, Per
(author)
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Griškevičius, Laimonas
(author)
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Hallböök, HeleneUppsala universitet,Hematologi(Swepub:uu)helehall
(author)
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Heyman, MatsKarolinska Institutet
(author)
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Holm, Mette Skov
(author)
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Hulegårdh, Erik
(author)
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Klausen, Tobias Wirenfeldt
(author)
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Marquart, Hanne V
(author)
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Jónsson, Olafur Gísli
(author)
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Nielsen, Ove Juul
(author)
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Quist-Paulsen, Petter
(author)
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Taskinen, Mervi
(author)
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Vaitkeviciene, Goda
(author)
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Vettenranta, Kim
(author)
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Asberg, Ann
(author)
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Schmiegelow, Kjeld
(author)
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Uppsala universitetHematologi
(creator_code:org_t)
Related titles
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In:European Journal of Haematology: Wiley90:5, s. 404-4120902-44411600-0609
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Toft, Nina
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Birgens, Henrik
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Hallböök, Helene
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Heyman, Mats
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Holm, Mette Skov
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Nielsen, Ove Juu ...
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Quist-Paulsen, P ...
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Asberg, Ann
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