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An MRD-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with ALL

Pediatric regimens have improved outcomes in adolescent and young adult (AYA) acute lymphoblastic leukemia (ALL). However, results remain inferior to children with ALL. The Australasian Leukaemia and Lymphoma Group (ALLG) ALL06 study (anzctr.org.au/ACTRN12611000814976) was designed to assess whether...

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Autores principales: Greenwood, Matthew, Trahair, Toby, Sutton, Rosemary, Osborn, Michael, Kwan, John, Mapp, Sally, Howman, Rebecca, Anazodo, Antoinette, Wylie, Brenton, D’Rozario, James, Hertzberg, Mark, Irving, Ian, Yeung, David, Coyle, Luke, Jager, Amanda, Engeler, Dan, Venn, Nicola, Frampton, Chris, Wei, Andrew H., Bradstock, Kenneth, Dalla-Pozza, Luciano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society of Hematology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714725/
https://www.ncbi.nlm.nih.gov/pubmed/34662896
http://dx.doi.org/10.1182/bloodadvances.2021005576
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author Greenwood, Matthew
Trahair, Toby
Sutton, Rosemary
Osborn, Michael
Kwan, John
Mapp, Sally
Howman, Rebecca
Anazodo, Antoinette
Wylie, Brenton
D’Rozario, James
Hertzberg, Mark
Irving, Ian
Yeung, David
Coyle, Luke
Jager, Amanda
Engeler, Dan
Venn, Nicola
Frampton, Chris
Wei, Andrew H.
Bradstock, Kenneth
Dalla-Pozza, Luciano
author_facet Greenwood, Matthew
Trahair, Toby
Sutton, Rosemary
Osborn, Michael
Kwan, John
Mapp, Sally
Howman, Rebecca
Anazodo, Antoinette
Wylie, Brenton
D’Rozario, James
Hertzberg, Mark
Irving, Ian
Yeung, David
Coyle, Luke
Jager, Amanda
Engeler, Dan
Venn, Nicola
Frampton, Chris
Wei, Andrew H.
Bradstock, Kenneth
Dalla-Pozza, Luciano
author_sort Greenwood, Matthew
collection PubMed
description Pediatric regimens have improved outcomes in adolescent and young adult (AYA) acute lymphoblastic leukemia (ALL). However, results remain inferior to children with ALL. The Australasian Leukaemia and Lymphoma Group (ALLG) ALL06 study (anzctr.org.au/ACTRN12611000814976) was designed to assess whether a pediatric ALL regimen (Australian and New Zealand Children’s Haematology and Oncology Group [ANZCHOG] Study 8) could be administered to patients aged 15 to 39 years in a comparable time frame to children as assessed by the proportion of patients completing induction/consolidation and commencing the next phase of therapy (protocol M or high-risk [HR] treatment) by day 94. Minimal residual disease (MRD) response stratified patients to HR treatment and transplantation. From 2012 to 2018, a total of 86 patients were enrolled; 82 were eligible. Median age was 22 years (range, 16-38 years). Induction/consolidation was equally deliverable in ALL06 as in Study 8. In ALL06, 41.5% (95% confidence interval [CI], 30.7-52.9) commenced protocol M or HR therapy by day 94 vs 39.3% in Study 8 (P = .77). Median time to protocol M/HR treatment was 96 days (interquartile range, 87.5-103 days) in ALL06 vs 98 days in Study 8 (P = .80). Induction mortality was 3.6%. With a median follow-up of 44 months (1-96 months), estimated 3-year disease-free survival was 72.8% (95% CI, 62.8-82.7), and estimated 3-year overall survival was 74.9% (95% CI, 65.3-84.5). End induction/consolidation MRD negativity rate was 58.6%. Body mass index ≥30 kg/m(2) and day 79 MRD positivity were associated with poorer disease-free survival and overall survival. Pediatric therapy was safe and as deliverable in AYA patients as in children with ALL. Intolerance of pediatric ALL induction/consolidation is not a major contributor to inferior outcomes in AYA ALL.
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spelling pubmed-87147252021-12-29 An MRD-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with ALL Greenwood, Matthew Trahair, Toby Sutton, Rosemary Osborn, Michael Kwan, John Mapp, Sally Howman, Rebecca Anazodo, Antoinette Wylie, Brenton D’Rozario, James Hertzberg, Mark Irving, Ian Yeung, David Coyle, Luke Jager, Amanda Engeler, Dan Venn, Nicola Frampton, Chris Wei, Andrew H. Bradstock, Kenneth Dalla-Pozza, Luciano Blood Adv Clinical Trials and Observations Pediatric regimens have improved outcomes in adolescent and young adult (AYA) acute lymphoblastic leukemia (ALL). However, results remain inferior to children with ALL. The Australasian Leukaemia and Lymphoma Group (ALLG) ALL06 study (anzctr.org.au/ACTRN12611000814976) was designed to assess whether a pediatric ALL regimen (Australian and New Zealand Children’s Haematology and Oncology Group [ANZCHOG] Study 8) could be administered to patients aged 15 to 39 years in a comparable time frame to children as assessed by the proportion of patients completing induction/consolidation and commencing the next phase of therapy (protocol M or high-risk [HR] treatment) by day 94. Minimal residual disease (MRD) response stratified patients to HR treatment and transplantation. From 2012 to 2018, a total of 86 patients were enrolled; 82 were eligible. Median age was 22 years (range, 16-38 years). Induction/consolidation was equally deliverable in ALL06 as in Study 8. In ALL06, 41.5% (95% confidence interval [CI], 30.7-52.9) commenced protocol M or HR therapy by day 94 vs 39.3% in Study 8 (P = .77). Median time to protocol M/HR treatment was 96 days (interquartile range, 87.5-103 days) in ALL06 vs 98 days in Study 8 (P = .80). Induction mortality was 3.6%. With a median follow-up of 44 months (1-96 months), estimated 3-year disease-free survival was 72.8% (95% CI, 62.8-82.7), and estimated 3-year overall survival was 74.9% (95% CI, 65.3-84.5). End induction/consolidation MRD negativity rate was 58.6%. Body mass index ≥30 kg/m(2) and day 79 MRD positivity were associated with poorer disease-free survival and overall survival. Pediatric therapy was safe and as deliverable in AYA patients as in children with ALL. Intolerance of pediatric ALL induction/consolidation is not a major contributor to inferior outcomes in AYA ALL. American Society of Hematology 2021-12-20 /pmc/articles/PMC8714725/ /pubmed/34662896 http://dx.doi.org/10.1182/bloodadvances.2021005576 Text en © 2021 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.
spellingShingle Clinical Trials and Observations
Greenwood, Matthew
Trahair, Toby
Sutton, Rosemary
Osborn, Michael
Kwan, John
Mapp, Sally
Howman, Rebecca
Anazodo, Antoinette
Wylie, Brenton
D’Rozario, James
Hertzberg, Mark
Irving, Ian
Yeung, David
Coyle, Luke
Jager, Amanda
Engeler, Dan
Venn, Nicola
Frampton, Chris
Wei, Andrew H.
Bradstock, Kenneth
Dalla-Pozza, Luciano
An MRD-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with ALL
title An MRD-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with ALL
title_full An MRD-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with ALL
title_fullStr An MRD-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with ALL
title_full_unstemmed An MRD-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with ALL
title_short An MRD-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with ALL
title_sort mrd-stratified pediatric protocol is as deliverable in adolescents and young adults as in children with all
topic Clinical Trials and Observations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714725/
https://www.ncbi.nlm.nih.gov/pubmed/34662896
http://dx.doi.org/10.1182/bloodadvances.2021005576
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