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2014 ; 120
(23
): 3660-8
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Augmented Berlin-Frankfurt-Münster therapy in adolescents and young adults (AYAs)
with acute lymphoblastic leukemia (ALL)
#MMPMID25042398
Rytting ME
; Thomas DA
; O'Brien SM
; Ravandi-Kashani F
; Jabbour EJ
; Franklin AR
; Kadia TM
; Pemmaraju N
; Daver NG
; Ferrajoli A
; Garcia-Manero G
; Konopleva MY
; Cortes JE
; Borthakur G
; Garris R
; Cardenas-Turanzas M
; Schroeder K
; Jorgensen JL
; Kornblau SM
; Kantarjian HM
Cancer
2014[Dec]; 120
(23
): 3660-8
PMID25042398
show ga
BACKGROUND: Various trials have reported improved outcomes for adolescents and
young adults (AYAs) with acute lymphoblastic leukemia (ALL) who received
treatment with pediatric-based regimens. Those reports prompted the current
investigation of the pediatric augmented Berlin-Frankfurt-Münster (ABFM) regimen
in AYA patients. The results were compared with those from a similar population
that received the hyperfractionated cyclophosphamide, vincristine, doxorubicin,
and dexamethasone (hyper-CVAD) regimen. METHODS: Eighty-five patients ages 12 to
40 years who had Philadelphia chromosome (Ph)-negative ALL received the ABFM
regimen from October 2006 through April 2012. Their outcome was compared with
outcomes in 71 historic AYA patients who received hyper-CVAD from the authors'
institution. Patient and disease characteristics, as well as minimal residual
disease status, were analyzed for their impact on outcomes. RESULTS: The complete
response rate with ABFM was 94%. The 3-year complete remission duration (CRD) and
overall survival (OS) rates were 70% and 74%, respectively. For patients aged ?21
years, the 3-year CRD and OS rates were 72% and 85%, respectively; and, for
patients ages 21 to 40 years, the respective rates were 69% and 60%. The initial
white blood cell count was an independent predictive factor of OS and CRD. The
minimal residual disease status on days 29 and 84 of therapy also were predictive
of long-term outcomes. Severe regimen toxicities included transient
hepatotoxicity in 35% to 39% of patients, pancreatitis in 11% of patients,
osteonecrosis in 11% of patients, and thrombosis in 22% of patients. The 3-year
OS rate was 74% in the ABFM group versus 71% in the hyper-CVAD group, and the
corresponding 3-year CRD rate was 70% versus 66%, respectively. CONCLUSIONS: ABFM
was tolerable in AYA patients with ALL but was not associated with significant
improvements in CRD and OS compared with hyper-CVAD.
|Adolescent
[MESH]
|Adult
[MESH]
|Antineoplastic Combined Chemotherapy Protocols/administration &
dosage/*therapeutic use
[MESH]