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10.1002/cncr.28930

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suck abstract from ncbi


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pmid25042398      Cancer 2014 ; 120 (23): 3660-8
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  • Augmented Berlin-Frankfurt-Münster Therapy in Adolescents and Young Adults (AYA) 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 PMID25042398show ga
  • Background: Various trials report improved outcomes for adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) treated with pediatric- based regimens. This prompted the investigation of the pediatric Augmented Berlin-Frankfurt-Münster (ABFM) regimen in AYA patients. Results were compared with the hyper?fractionated cyclophosphamide, vincristine, Adriamycin and dexamethasone (hyper-CVAD) regimen in a similar population. Methods: Eighty-five patients age 12 to 40 years with Philadelphia chromosome- (Ph) negative ALL were treated with ABFM from 10/2006 through 4/2012. Their outcome was compared to 71 historical AYA patients treated with hyper-CVAD from our institution. Patient and disease characteristics, as well as status of minimal residual disease (MRD), were analyzed for their impact on outcomes. Results: The complete remission (CR) rate with ABFM was 94%. The 3-year complete remission duration (CRD) and overall survival (OS) rates were 70% and 74%, respectively. The 3-year CRD and OS were 72% and 85%, respectively, with age ? 21 years, and 69% and 60%, respectively, with age 21-40 years. Initial white blood cell count was an independent predictive factor of OS and CRD. The MRD status on Day 29 and Day 84 of therapy were also predictive of long-term outcomes. Severe regimen toxicities included transient hepatotoxicity in 35-39%, pancreatitis in 11%, osteonecrosis in 11%, and thrombosis in 22%. The 3-year OS rate was 74% with ABFM versus 71% with hyper-CVAD; the 3-year CRD rate was 70% with ABFM versus 66% with hyper-CVAD. Conclusion: ABFM was tolerable in AYA patients with ALL but was not associated with significant improvements in CRD and OS compared with hyper-CVAD.
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