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Clinical Trial
. 2016 Nov;91(11):1107-1112.
doi: 10.1002/ajh.24497. Epub 2016 Aug 22.

Delays in postremission chemotherapy for Philadelphia chromosome negative acute lymphoblastic leukemia are associated with inferior outcomes in patients who undergo allogeneic transplant: An analysis from ECOG 2993/MRC UK ALLXII

Anita J Kumar  1 , Phyllis A Gimotty  2 , Joel M Gelfand  3 , Georgina Buck  4 , Jacob M Rowe  5   6 , Anthony H Goldstone  7 , Adele Fielding  8 , David I Marks  9 , Mark Litzow  10 , Elisabeth Paietta  11 , Hillard M Lazarus  12 , Martin S Tallman  13 , Selina M Luger  14 , Alison W Loren  14
Affiliations
Clinical Trial

Delays in postremission chemotherapy for Philadelphia chromosome negative acute lymphoblastic leukemia are associated with inferior outcomes in patients who undergo allogeneic transplant: An analysis from ECOG 2993/MRC UK ALLXII

Anita J Kumar et al. Am J Hematol. 2016 Nov.

Erratum in

Abstract

Adults with acute lymphoblastic leukemia (ALL) have a poorer prognosis than children due to a high risk of relapse. One explanation may be variable adherence to dose-intense chemotherapy. However, little is known about risk factors for delays in therapy and their impact on survival. We conducted an analysis of ECOG 2993/UKALLXII trial to study delays in postremission chemotherapy in adults with newly diagnosed ALL. Logistic regression was used to identify risk factors for a very long delay (VLD, >4 weeks) in start of intensification therapy. Cox regression was used to evaluate the impact of delays on overall survival (OS) and event-free survival (EFS). We evaluated 1076 Philadelphia chromosome negative (Ph-) patients who completed induction chemotherapy, achieved complete remission, and started intensification. Factors independently associated with VLD included duration of hospitalization (odds ratio [OR] = 1.2, P < 0.001) during Phase I; thrombocytopenia during Phase I (OR = 1.16, P = 0.004) or Phase II (OR 1.13, P = 0.001); chemotherapy dose reductions during Induction Phase I (OR = 1.72, P < 0.014); female sex (OR = 1.53, P = 0.010); Black (OR = 3.24, P = 0.003) and Asian (OR = 2.26, P = 0.021) race; and increasing age (OR = 1.31, P < 0.001). In multivariate Cox regression, patients who underwent allogeneic stem cell transplant (alloHCT) had significantly worse OS (HR 1.4, P = 0.03) and EFS (HR 1.4, P = 0.02) after experiencing a VLD compared to alloHCT patients who experienced ≤4 weeks delay. Specific populations (female, older, Black, and Asian patients) were more likely to experience delays in chemotherapy, as were those with significant toxicity during induction. VLDs in therapy negatively affected outcomes in patients undergoing allografting. Am. J. Hematol. 91:1107-1112, 2016. © 2016 Wiley Periodicals, Inc.

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Figure 1
Figure 1
OS: overall survival; VLD: very long delay; SD: short delay; LD: long delay
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References

    1. Pui CH, Evans WE. Treatment of acute lymphoblastic leukemia. The New England journal of medicine. 2006;354:166–178. - PubMed
    1. Rijneveld AW, van der Holt B, Daenen SM, Biemond BJ, de Weerdt O, Muus P, Maertens J, Mattijssen V, Demuynck H, Legdeur MC, Wijermans PW, Wittebol S, Spoelstra FM, Dekker AW, Ossenkoppele GJ, Willemze R, Cornelissen JJ. Intensified chemotherapy inspired by a pediatric regimen combined with allogeneic transplantation in adult patients with acute lymphoblastic leukemia up to the age of 40. Leukemia. 2011;25:1697–1703. - PubMed
    1. Boucheix C, David B, Sebban C, Racadot E, Bene MC, Bernard A, Campos L, Jouault H, Sigaux F, Lepage E, et al. Immunophenotype of adult acute lymphoblastic leukemia, clinical parameters, and outcome: an analysis of a prospective trial including 562 tested patients (LALA87). French Group on Therapy for Adult Acute Lymphoblastic Leukemia. Blood. 1994;84:1603–1612. - PubMed
    1. Pui CH, Relling MV, Downing JR. Acute lymphoblastic leukemia. The New England journal of medicine. 2004;350:1535–1548. - PubMed
    1. Thomas X, Le QH. Prognostic factors in adult acute lymphoblastic leukemia. Hematology. 2003;8:233–242. - PubMed

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