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. 2010 Mar;51(3):475-80.
doi: 10.3109/10428190903503412. Epub 2010 Jan 18.

Outcome of adults with acute lymphocytic leukemia in second or subsequent complete remission

Hagop M Kantarjian  1 , Deborah Thomas, Farhad Ravandi, Stefan Faderl, Guillermo Garcia-Manero, Jianquin Shan, Sherry Pierce, Jorge Cortes, Susan O'Brien
Affiliations

Outcome of adults with acute lymphocytic leukemia in second or subsequent complete remission

Hagop M Kantarjian et al. Leuk Lymphoma. 2010 Mar.

Abstract

The outcome of adults with acute lymphocytic leukemia (ALL) who achieve a complete response (CR) on salvage therapy is thought to be poor, but not previously analyzed. To define the course of adult ALL post CR on salvage therapy and the effects of pretreatment factors on prognosis. One hundred seventy-two adults with ALL who achieved a second or third CR on salvage therapy were reviewed. Prognostic factors affecting survival were analyzed by multivariate analysis. The median survival post achieving CR for the entire group was 10 months. The estimated 1-year survival rate was 42%. Forty-three patients underwent stem cell transplant in subsequent CR: their median survival was 12 months and the 3-year survival rate was 25%. Independent poor prognostic factors for survival were age > 55 years, duration of first CR < 12 months, and lactate dehydrogenase levels > 1000 IU/L. This analysis defines the outcome of adult ALL in CR post salvage therapy and the prognostic factors influencing survival. These results could be used in assessing the efficacy of new treatments aimed at improving CR durations and survival post salvage therapy.

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Figures

Figure 1
Figure 1
Survival in subsequent CR with and without censoring for time to allogeneic stem cell transplant (dated from time of subsequent CR). The survival of patients without censoring at the time of allogeneic stem cell transplant is slightly but not significantly better (dotted curve) suggesting that the procedure did not change drastically the outcome of the total study group.
Figure 2
Figure 2
Survival of patients achieving second or third remission (dated from subsequent treatment).
Figure 3
Figure 3
Survival post allogeneic stem cell transplant in second or subsequent remission (dated from stem cell transplant).
Figure 4
Figure 4
Survival by number of adverse factors.
See this image and copyright information in PMC

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