Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2009 Dec 10;114(25):5136-45.
doi: 10.1182/blood-2009-08-231217.

T-cell acute lymphoblastic leukemia in adults: clinical features, immunophenotype, cytogenetics, and outcome from the large randomized prospective trial (UKALL XII/ECOG 2993)

David I Marks  1 , Elisabeth M Paietta, Anthony V Moorman, Susan M Richards, Georgina Buck, Gordon DeWald, Adolfo Ferrando, Adele K Fielding, Anthony H Goldstone, Rhett P Ketterling, Mark R Litzow, Selina M Luger, Andrew K McMillan, Marc R Mansour, Jacob M Rowe, Martin S Tallman, Hillard M Lazarus
Affiliations
Randomized Controlled Trial

T-cell acute lymphoblastic leukemia in adults: clinical features, immunophenotype, cytogenetics, and outcome from the large randomized prospective trial (UKALL XII/ECOG 2993)

David I Marks et al. Blood. .

Abstract

The biology and outcome of adult T-cell acute lymphoblastic leukemia are poorly understood. We present here the clinical and biologic features of 356 patients treated uniformly on the prospective trial (UKALL XII/ECOG 2993) with the aim of describing the outcome and identifying prognostic factors. Complete remission was obtained in 94% of patients, and 48% survived 5 years. Positivity of blasts for CD1a and lack of expression of CD13 were associated with better survival (P = .01 and < .001, respectively). NOTCH1 and CDKN2A mutations were seen in 61% and 42% of those tested. Complex cytogenetic abnormalities were associated with poorer survival (19% vs 51% at 5 years, P = .006). Central nervous system involvement at diagnosis did not affect survival (47% vs 48%, P = not significant). For 99 patients randomized between autograft and chemotherapy, 5-year survival was 51% in each arm. Patients with a matched sibling donor had superior 5-year survival to those without donors (61% vs 46%, chi(2), P = .02); this was the result of less relapse (25% vs 51% at 5 years, P < .001). Only 8 of 123 relapsed patients survive. This study provides a baseline for trials of new drugs, such as nelarabine, and may allow risk-adapted therapy in patients with poor-prognosis T-cell ALL.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patient flow diagram.
Figure 2
Figure 2
Overall survival from diagnosis of patients with B- versus T- lineage disease.
Figure 3
Figure 3
Overall survival from diagnosis by WBC in patients with T-lineage ALL.
Figure 4
Figure 4
Effect of randomized treatment on overall survival in patients. (A) Survival curve in patients with T lineage. (B) Forest plot within lineage subgroups. Survival was measured from randomization. The forest plot represents the treatment effect (odds ratio) and its 95% CI by a square and horizontal line (within subgroups) and the center and width of a diamond (overall).
Figure 5
Figure 5
Effect of matched sibling donor availability on outcome. (A) Survival curve in patients with T lineage. (B) Forest plot of effects on relapse and on nonrelapse mortality within lineage subgroups. Survival was measured from diagnosis. Forest plot format is as in Figure 4.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Goldstone AH, Richards SM, Lazarus HM, et al. In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/ maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993). Blood. 2008;111(4):1827–1833. - PubMed
    1. Vitale A, Guarini A, Ariola C, et al. Adult T-cell acute lymphoblastic leukemia: biologic profile at presentation and correlation with response to induction treatment in patients enrolled in the GIMEMA LAL 0496 protocol. Blood. 2006;107(2):473–479. - PubMed
    1. Rowe JM, Buck G, Burnett AK, et al. Induction therapy for adults with acute lymphoblastic leukaemia: results of more than 1500 patients from the international ALL trial MRC UKALL XII/ECOG 2993. Blood. 2005;106(12):3760–3767. - PubMed
    1. Hunault M, Harousseau JL, Delain M, et al. Better outcome of adult acute lymphoblastic leukemia after early genoidentical allogeneic bone marrow transplantation (BMT) than after late high dose therapy and autologous BMT: a GOELAMS trial. Blood. 2004;104(12):3028–3037. - PubMed
    1. Lazarus HM, Richards SM, Chopra R, et al. CNS involvement in adult acute lymphoblastic leukaemia at diagnosis: results from the international ALL trial MRC UKALL XII/ECOG 2993. Blood. 2006;108(2):465–472. - PMC - PubMed

Publication types

MeSH terms

Substances