Improved outcomes in elderly patients with acute lymphoblastic leukaemia using a paediatric-based protocol-A...

Area of Science:

• Hematology
• Oncology
• Geriatrics

Background:

• Elderly patients with acute lymphoblastic leukaemia (ALL) have a historically poor prognosis.
• Improvements in ALL outcomes for younger patients have not translated equally to the elderly population.
• There is a need for effective and tolerable treatment strategies for older adults with ALL.

Purpose of the Study:

• To assess the feasibility and effectiveness of a paediatric-based treatment regimen in newly diagnosed elderly patients (≥65 years) with ALL.
• To evaluate outcomes including remission rates, survival, and relapse in this specific patient cohort.

Main Methods:

• Prospective, population-based study conducted in Norway.
• Patients received a paediatric-based regimen: pegylated asparaginase for Philadelphia chromosome (Ph)-negative ALL, imatinib for Ph-positive ALL.
• Dose reductions were permitted for frail patients; treatment stratified by Ph status.

Main Results:

• 52 elderly patients with ALL were enrolled (median age 70 years).
• 49 patients achieved remission; 2-year and 5-year overall survival rates were 60% and 50%, respectively.
• Low relapse rates were observed, with only six relapses among 36 patients who did not die from other causes.

Conclusions:

• A paediatric-based protocol is well-tolerated and effective in elderly patients with newly diagnosed ALL.
• This regimen achieves favorable outcomes, including a 50% long-term survival rate and low relapse rates.
• The findings support the use of adapted paediatric protocols for managing ALL in older adults.