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Acute lymphoblastic leukemia experience: epidemiology and outcome of two different regimens
Salah Abbasi1, Faten Maleha, Muhannad Shobaki
1Department of Internal Medicine and Medical Oncology, King Hussein Cancer Center, Amman, Jordan.
Insights
Accurate data on adult acute lymphoblastic leukemia (ALL) treatment in Jordan is presented. The Hyper-CVAD and CALGB 8811 regimens showed similar efficacy, with BCR-ABL translocation being a poor prognostic factor.
Area of Science:
- Hematology
- Oncology
- Clinical Research
Background:
- Limited data exists on adult acute lymphoblastic leukemia (ALL) treatment outcomes in Jordan.
- The King Hussein Cancer Center (KHCC) initiated a study to address this data gap.
Purpose of the Study:
- To assess the demographics, prognostic factors, and treatment outcomes of adult ALL patients at KHCC.
- To compare the efficacy of two chemotherapy protocols: Hyper-CVAD and CALGB 8811.
Main Methods:
- Retrospective review of medical records for adult ALL patients treated at KHCC between January 2007 and December 2011.
- Analysis of patient demographics, immunophenotype, BCR-ABL translocation status, treatment regimens, response rates, and survival data.
Main Results:
- 108 adult ALL patients were treated, with a median age of 33 years; 63% were male.
- Complete response rate was 88%. Median survival was 30 months, and median CR duration was 28 months.
- BCR-ABL translocation was the sole poor prognostic factor (p<0.01), associated with reduced median survival (23 months). No significant difference in outcomes was observed between the Hyper-CVAD and CALGB 8811 regimens.
Conclusions:
- International treatment protocols for adult ALL can be successfully implemented in the Jordanian population.
- The Hyper-CVAD and CALGB 8811 regimens demonstrated comparable efficacy in this cohort.
- Future research should explore targeted agents and minimal residual disease monitoring to enhance treatment outcomes for adult ALL.
Objectives:
Accurate data about adult acute lymphoblastic leukemia (ALL) are lacking. We aim to assess demographics, prognostic factors, and outcome of ALL therapy at King Hussein Cancer Center (KHCC) in Jordan, and to compare the efficacy of two protocols.
Methods:
We reviewed medical records of adults diagnosed and treated for ALL at KHCC from January, 2007 to December, 2011.
Results:
Over a 5-year period, 108 patients with ALL were treated (66 with the Hyper-CVAD regimen, and 42 with the CALGB 8811 regimen). Median age at diagnosis was 33 years, with 63% males. The most common immunophenotype was CD10-positive common ALL, and 16% have BCR-ABL translocation. Complete response (CR) rate was 88%. After a median follow-up of 32 months (range, 10-72 months), the median survival (MS) was 30 months, and CR duration (CRD) was 28 months. In the multivariate analysis, the presence of BCR-ABL translocation was the only poor prognostic factor with lower MS of 23 months (p<0.01). There was no difference in MS or CRD between the two used regimens.
Conclusion:
International protocols for adult ALL were successfully applied to our patients. There is no difference in efficacy between Hyper-CVAD and CALGB 8811 regimens. Future protocols for adult ALL should incorporate new targeted agents and minimal residual disease monitoring to improve outcome.
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