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. 2019 Aug;103(2):88-98.
doi: 10.1111/ejh.13247. Epub 2019 Jun 6.

Survival in adult acute lymphoblastic leukaemia (ALL): A report from the Swedish ALL Registry

Emma Lennmyr  1 , Karin Karlsson  2 , Lucia Ahlberg  3 , Hege Garelius  4 , Erik Hulegårdh  4 , Antonio S Izarra  5 , Joel Joelsson  6 , Piotr Kozlowski  7 , Andreea Moicean  8 , Beata Tomaszewska-Toporska  2 , Anna Lübking  2 , Helene Hallböök  1 ; Swedish Adult Acute Lymphoblastic Leukaemia Group (SVALL)
Affiliations

Survival in adult acute lymphoblastic leukaemia (ALL): A report from the Swedish ALL Registry

Emma Lennmyr et al. Eur J Haematol. 2019 Aug.

Abstract

Objectives: As new, effective therapies emerge for acute lymphoblastic leukaemia (ALL), the results of clinical trials need to relate to standard of care.

Methods: We used the population-based Swedish ALL Registry to evaluate characteristics, treatment and long-term outcome in 933 patients with diagnosis between 1997 and 2015.

Results: The median age was 53 years. The frequency of Philadelphia (Ph)-positive leukaemia was 34% of examined B-ALL with a peak incidence at 50-59 years. Five-year overall survival (OS) improved between 1997-2006 and 2007-2015; in patients 18-45 years from 50% (95% CI 43-57) to 65% (95% CI 58-72), 46-65 years from 25% (95% CI 18-32) to 46% (95% CI 37-55) and >65 years from 7% (95% CI 2.6-11) to 11% (95% CI 5.9-16) (P < 0.05). Men with Ph-neg B-ALL 46-65 years had inferior OS compared with women (P < 0.01). Standardised mortality ratio was 5.7 (95% CI 5.0-6.3) for patients who survived 5 years from diagnosis. In multivariable analysis, Ph-positive disease was not associated with impaired prognosis but with lower risk of death in 2007-2015.

Conclusions: In a population-based cohort, OS has improved in adult ALL, especially for Ph-positive disease but for middle-aged men with Ph-negative B-ALL outcome was poor. Cure without late toxicity or relapse is still desired.

Keywords: Philadelphia-positive; acute lymphoblastic leukaemia; adult.

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Conflict of interest statement

The authors declare no conflict of interests.

Figures

Figure 1
Figure 1
Philadelphia‐positive disease of tested B‐ALL in different age groups
Figure 2
Figure 2
Overall survival in the total cohort (n = 930) in 1997‐2006 and 2007‐2015. Five‐year overall survival improved in patients 18‐45 y from 50% (95% CI 43‐57) to 65% (95% CI 58‐72), in patients 46‐65 y from 25% (95% CI 18‐32) to 46% (95% CI 37‐55), and in patients >65 y from 7% (95% CI 2.6‐11) to 11% (95% CI 5.9‐16) (P = <0.05, log‐rank for pairwise comparison) [Colour figure can be viewed at http://wileyonlinelibrary.com]
Figure 3
Figure 3
Overall survival (OS) in Philadelphia‐negative ALL in 1997‐2006 and 2007‐2015. A, Five‐year OS 1997‐2006 in patients 18‐45 y was 50% (95% CI 43‐58), in patients 46‐65 y 25% (95% CI 18‐33) and in patients >65 7% (95% CI 2‐12). B, Five‐year OS 2007‐2015 in patients 18‐45 y was 65% (95% CI 58‐73), in patients 46‐65 y 42% (95% CI 31‐53) and in patients >65 y 9% (95% CI 4‐15) [Colour figure can be viewed at http://wileyonlinelibrary.com]
Figure 4
Figure 4
Overall survival (OS) in Philadelphia‐positive ALL in 1997‐2006 and 2007‐2015. A, Five‐year OS 1997‐2006 in patients 18‐45 y was 48% (95% CI 30‐67), in patients 46‐65 y 24% (95% CI 7‐41) and in patients >65 y 0%. B, Five‐year OS 2007‐2015 in patients 18‐45 y was 64% (95% CI 47‐81), in patients 46‐65 y 56% (95% CI 40‐72) and in patients >65 y 18% (95% CI 5‐31) [Colour figure can be viewed at http://wileyonlinelibrary.com]
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References

    1. Dinmohamed AG, Szabo A, van der Mark M, et al. Improved survival in adult patients with acute lymphoblastic leukemia in the Netherlands: a population‐based study on treatment, trial participation and survival. Leukemia. 2016;30:310‐317. - PubMed
    1. Dores GM, Devesa SS, Curtis RE, Linet MS, Morton LM. Acute leukemia incidence and patient survival among children and adults in the United States, 2001–2007. Blood. 2012;119:34‐43. - PMC - PubMed
    1. Toft N, Schmiegelow K, Klausen TW, Birgens H Adult acute lymphoblastic leukaemia in Denmark. A national population‐based retrospective study on acute lymphoblastic leukaemia in Denmark 1998–2008. Br J Haematol. 2012;157:97‐104. - PubMed
    1. Guru Murthy GS, Venkitachalam R, Mehta P. Trends in survival outcomes of B‐lineage acute lymphoblastic leukemia in elderly patients: analysis of Surveillance, Epidemiology, and End Results database. Leuk Lymphoma. 2015;56:2296‐2300. - PubMed
    1. Igwe IJ, Yang D, Merchant A, et al. The presence of Philadelphia chromosome does not confer poor prognosis in adult pre‐B acute lymphoblastic leukaemia in the tyrosine kinase inhibitor era ‐ a surveillance, epidemiology, and end results database analysis. Br J Haematol. 2017;179:618‐626. - PMC - PubMed

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