Outcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL); an MRC UKALL12/ECOG 2993 study.
AuthorsFielding, Adele K
Richards, Susan M
Lazarus, Hillard M
Litzow, Mark R
Durrant, I Jill
Luger, Selina M
Marks, David I
Franklin, Ian M
McMillan, Andrew K
Tallman, Martin S
Rowe, Jacob M
Goldstone, Anthony H
AffiliationRoyal Free and University College London Medical School, and Christie Hospital National Health Service Trust, Manchester, UK. email@example.com
MetadataShow full item record
AbstractMost adults with acute lymphoblastic leukemia (ALL) who achieve complete remission (CR) will relapse. We examined the outcome of 609 adults with recurring ALL, all of whom were previously treated on the Medical Research Council (MRC) UKALL12/ECOG2993 study, where the overall survival (OS) of newly diagnosed patients is 38% (95% confidence interval [CI]=36%-41%) at 5 years. By contrast, OS at 5 years after relapse was 7% (95% CI=4%-9%). Factors predicting a good outcome after salvage therapy were young age (OS of 12% in patients younger than 20 years vs OS of 3% in patients older than 50 years; 2P<.001) and short duration of first remission (CR1) (OS of 11% in those with a CR1 of more than 2 years versus OS of 5% in those with a CR1 of less than 2 years; 2P<.001). Treatment received in CR1 did not influence outcome after relapse. In a very highly selected subgroup of patients who were able to receive HSCT after relapse, some were long-term survivors. We conclude from a large, unselected series with mature follow-up that most adults with recurring ALL, whatever their prior treatment, cannot be rescued using currently available therapies. Prevention of recurrence is the best strategy for long-term survival in this disease.
CitationOutcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL); an MRC UKALL12/ECOG 2993 study. 2007, 109 (3):944-50 Blood
- Outcome after first relapse in adult patients with Philadelphia chromosome-negative acute lymphoblastic leukaemia.
- Authors: Kako S, Kanamori H, Kobayashi N, Shigematsu A, Nannya Y, Nakamae M, Shigeno K, Suzukawa K, Takeuchi M, Tsuzuki M, Usuki K, Hatanaka K, Ogawa K, Mitani K, Nawa Y, Hatta Y, Mizuno I, Kanda Y
- Issue date: 2013 Apr
- Outcome after relapse of acute lymphoblastic leukemia in adult patients included in four consecutive risk-adapted trials by the PETHEMA Study Group.
- Authors: Oriol A, Vives S, Hernández-Rivas JM, Tormo M, Heras I, Rivas C, Bethencourt C, Moscardó F, Bueno J, Grande C, del Potro E, Guardia R, Brunet S, Bergua J, Bernal T, Moreno MJ, Calvo C, Bastida P, Feliu E, Ribera JM, Programa Español de Tratamiento en Hematologia Group
- Issue date: 2010 Apr
- Outcomes and prognostic factors of adults with acute lymphoblastic leukemia who relapse after allogeneic hematopoietic cell transplantation. An analysis on behalf of the Acute Leukemia Working Party of EBMT.
- Authors: Spyridonidis A, Labopin M, Schmid C, Volin L, Yakoub-Agha I, Stadler M, Milpied N, Socie G, Browne P, Lenhoff S, Sanz MA, Aljurf M, Mohty M, Rocha V, Immunotherapy Subcommittee of Acute Leukemia Working Party
- Issue date: 2012 Jun
- Prospective outcome data on 267 unselected adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia confirms superiority of allogeneic transplantation over chemotherapy in the pre-imatinib era: results from the International ALL Trial MRC UKALLXII/ECOG2993.
- Authors: Fielding AK, Rowe JM, Richards SM, Buck G, Moorman AV, Durrant IJ, Marks DI, McMillan AK, Litzow MR, Lazarus HM, Foroni L, Dewald G, Franklin IM, Luger SM, Paietta E, Wiernik PH, Tallman MS, Goldstone AH
- Issue date: 2009 May 7
- Primary refractory and relapsed adult acute lymphoblastic leukemia: characteristics, treatment results, and prognosis with salvage therapy.
- Authors: Thomas DA, Kantarjian H, Smith TL, Koller C, Cortes J, O'Brien S, Giles FJ, Gajewski J, Pierce S, Keating MJ
- Issue date: 1999 Oct 1