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High relapse rate of T cell acute lymphoblastic leukemia in adults treated with Hyper-CVAD chemotherapy in Sweden

Kozlowski, Piotr, 1969- (author)
Region Örebro län,Hematology Section, Department of Medicine, Örebro University Hospital, Örebro, Sweden
Åström, Maria, 1959- (author)
Region Örebro län,Hematology Section, Department of Medicine, Örebro University Hospital, Örebro, Sweden
Ahlberg, Lucia (author)
Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Hematologiska kliniken US
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Bernell, Per (author)
Karolinska University Hospital, Stockholm, Sweden
Hulegardh, Erik (author)
Department of Hematology and Coagulation, Sahlgrenska University, Göteborg, Sweden
Hägglund, Hans (author)
Uppsala universitet,Karolinska Institutet,Hematologi,Karolinska University Hospital, Sweden
Karlsson, Karin (author)
Lund University,Lunds universitet,Stamcellscentrum (SCC),Avdelningen för stamcellsforskning,Institutionen för laboratoriemedicin,Medicinska fakulteten,Stem Cell Center,Division of stem cell research,Department of Laboratory Medicine,Faculty of Medicine,Department of Hematology, Skåne University Hospital, Lund, Sweden
Markuszewska-Kuczymska, Alicja (author)
Umeå universitet,Onkologi,University Hospital, Sweden
Tomaszewska-Toporska, Beata (author)
Department of Hematology, Skåne University Hospital, Lund, Sweden
Smedmyr, Bengt (author)
Uppsala universitet,Hematologi,Uppsala University, Sweden
Amini, Rose-Marie (author)
Uppsala universitet,Molekylär och morfologisk patologi,Uppsala University, Sweden
Hallböök, Helene (author)
Uppsala universitet,Hematologi,Uppsala University, Sweden
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 (creator_code:org_t)
2014-02-21
2014
English.
In: European Journal of Haematology. - : Wiley. - 1600-0609 .- 0902-4441. ; 92:5, s. 377-381
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background Hyper-CVAD is widely used to treat acute lymphoblastic leukemia (ALL) and aggressive lymphomas. This multicenter, population-based study assessed the efficacy of Hyper-CVAD as first-line therapy in patients with T-cell ALL (T-ALL). Patients and methods Between October 2002 and September 2006, 24 patients were diagnosed with T-ALL in Sweden; 19 were eligible for treatment with the protocol. Results The median age was 32yr (range 18-72yr). Complete remission (CR) was obtained in 17 of 19 (89%) patients, and the treatment was relatively well tolerated. Allogeneic stem cell transplantation (SCT) was recommended in high-risk disease and was performed in four patients upfront. Two- and 5-yr leukemia-free survivals (LFS) in 17 patients with CR achievement were identical, at 29% (95% confidence interval [CI]: 8-51). Two- and 5-yr overall survival (OS) in whole cohort was 63% (95% CI: 42-85) and 47% (95% CI: 26-69), respectively. The 5-yr LFS for 15 patients who did not receive allogeneic SCT upfront were 20% (95% CI: 0-40), although 14 of 15 completed the protocol (eight cycles). Relapse occurred in 2 of 4 upfront-transplanted patients and in 12 of 15 patients treated with chemotherapy alone, six of whom received allogeneic SCT in CR2. Age >= 35yr influenced OS negatively in univariate analysis (HR 5.1, 95% CI: 1.55-16.7). Conclusions Hyper-CVAD treatment resulted in a high CR rate and appeared safe, but it showed poor efficacy at preventing relapse. Therefore, this treatment is no longer recommended for adults with T-ALL in Sweden.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Hematologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Hematology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Keyword

antineoplastic combined chemotherapy protocols
treatment outcome
precursor T-cell lymphoblastic leukemia-lymphoma
stem cell
transplantation
antineoplastic combined chemotherapy protocols; treatment outcome; precursor T-cell lymphoblastic leukemia-lymphoma; stem cell transplantation
MEDICINE

Publication and Content Type

art (subject category)
ref (subject category)

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