Outcome of adults with acute lymphoblastic leukemia treated with a pediatric-inspired therapy: a single institution experience

Survival analysis of adult patients with ALL in Mexico City: first report from the Acute Leukemia Workgroup (ALWG) (GTLA)

“…Another limitation of our study of a retrospective nature, is the scarce availability of certain immunophenotype markers such as aberrant myeloid markers; this precludes trustworthy correlation analyses between aberrant markers and the Philadelphia chromosome status, as well their inclusion in the survival analysis. ALL‐T cases were identified in 2.9%; which is less than previously reported by other authors in Mexico (5–10%) as well as in other countries (10–30%) . We do not have an explanation for this finding.…”

“…Furthermore, data collection allowed us to determine the principal areas of opportunity in the participating centers. Such is the case of caryotype testing that historically has been described as deficient in the past few years in Mexico ; however, some investigators have recently reported an improvement in this caveat as a result of the routine implementation of FISH or molecular techniques to identify cases of Ph + ‐ALL . Another multicentric study was recently conducted in Mexico, including six referral hematological centers, of a large series of patients with acute myeloid leukemia and ALL; however, they did not conduct a survival analysis nor risk factor identification.…”

“…Reports in Mexico have referred CR rates between 60% and 80% with hyper‐CVAD and other locally designed institutional regimens. Among the limitations of studies published in Mexico are the use of diverse treatment protocols that make interinstitutional comparisons difficult, the series are small, there are deficiencies in cytogenetic results (inaccessible or technique failures), all impinging on the reported incidence of Philadelphia‐positive ALL (Ph + ‐ALL); also, most studies lack a survival analysis and risk factor identification . A recent series of 94 patients at the Hospital Universitario de Monterrey, Nuevo León treated with the Berlin–Frankfurt–Münster (BFM) regimen, reported a CR of 71.3% and a 5‐year OS of 31.1%.…”

Geographic Hematology: Some Observations in Mexico

“…With regard to treatment of ALL, it has been shown that treatment protocols conducted on an outpatient basis are related to results similar to those of other more aggressive protocols endowed with a higher morbimortality but similar long-term results. As an example, we have shown that St. Jude's TOTAL XI-based protocols are as effective as Hyper-CVAD and, since they can be conducted on an outpatient basis, their use in Mexico is more realistic than that of other more complicated ones [23]. The mortality rate of Hyper-CVAD during its administration reaches more than 50% in some institutions, a figure substantially higher than that of the TOTAL XI-based schedules.…”

Advances in the diagnosis and treatment of acute and chronic leukemia in Mexico

“…In Mexico, outcomes obtained with less aggressive and complex schemes are as efficient as other approaches but are associated with lower morbimortality. 6 In addition, these schemes can be administered on an outpatient basis and are associated with better quality of life for the treated patient. For high-risk or relapsing patients with ALL, bone marrow transplantation (BMT) performed with reduced-strength schemes and on an outpatient basis is associated with favorable outcomes that are better than those obtained with combined chemotherapy.…”