Overall survival in patients with acute lymphoblastic leukemia treated with CALGB 8811 protocol in low income country

Abstract

Introduction: ALL is known to have a lower survival rate in adults and this can be attributed, among other aspects, to intolerance to intensive regimens. As the treatment of ALL is very complex, with many protocols available, this study proposes an analysis regarding the CALGB 8811 protocol in a tertiary health unit in Ceará
 Methods: In this retrospective study, 50 patients with a recent diagnosis of ALL who underwent the CALGB8811 protocol were evaluated. Disease risk criteria were based on the CALGB8811 protocol.
 Results: CR was obtained in 86% of patients. 12% of patients died during induction due to infectious complications. 30% of patients underwent alloSCT, 60% were on CR1.
 The median overall survival (OS) was 21.5 months (8.1-38.7). The 5 years OS was 25% in the transplanted patients versus 60% in the transplanted group. Achieving complete remission after induction chemotherapy and allogeneic hematopoietic stem cell transplantation were the factors associated with better long-term survival rates in uni and multivariate analysis.
 Conclusion: Risk factors classically associated with worse adult ALL outcome and post-induction MRD status were not outcome predictors, in addition, post-induction remission and alloSCT were factors associated with a favorable outcome.

Overall survival in patients with acute lymphoblastic leukemia treated with protocol CALGB 9511 at a tertiary hospital in the state of Ceará.

“…Risk stratification is essential to define which patients should be referred to a specialized bone marrow transplant center after the first remission. 7 The CALGB 9511 protocol was developed based on intensive pediatric regimens. This protocol is divided into the phases of Induction, Intensifi-cation, Central Nervous System Prophylaxis, and Maintenance.…”

Leucemia linfoblástica aguda do adulto: resultados da otimização da avaliação genética e dos protocolos terapêuticos

“…Infelizmente, na América Latina, os poucos trabalhos avaliando os resultados obtidos em LLA do adulto evidenciam taxas de cura inferiores à de países desenvolvidos (21)(22)(23)(24). Maiores taxas de neutropenia febril, toxicidade sistêmica e menor aplicabilidade dos protocolos no contexto hospitalar contribuem com estes resultados inferiores (22,25).…”

“…Poucas iniciativas de pesquisa em LLA do adulto foram conduzidas na América Latina nos últimos anos. Levantamentos retrospectivos unicêntricos tem evidenciado que a sobrevida da população adulta é inferior à de países desenvolvidos (21)(22)(23)(24)(37)(38)(39).…”

“…24.2% (95 % CI 17.3-34), while the relapse incidence was 29.5%. Lactate dehydrogenase levels and central nervous disease were related to relapse in this cohort.…”