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. 2023 Jul;45 Suppl 2(Suppl 2):S108-S112.
doi: 10.1016/j.htct.2022.06.006. Epub 2022 Aug 1.

Outcome of adolescents and young adults with acute lymphoblastic leukemia in a single center in Brazil

Thais Ferraz Aguiar  1 , Thayana da Conceição Barbosa  2 , Ana Luiza Tardem Maciel  2 , Caroline Barbieri Blunck  2 , João Sellos-Laclette  2 , Andreia Cristina de Melo  2 , Marcela B Mansur  3 , Mariana Emerenciano  4
Affiliations

Outcome of adolescents and young adults with acute lymphoblastic leukemia in a single center in Brazil

Thais Ferraz Aguiar et al. Hematol Transfus Cell Ther. 2023 Jul.

Abstract

Introduction: Acute lymphoblastic leukemia (ALL) presents a poor prognosis in adults. The adoption of pediatric protocols has been changing this scenario, especially for adolescents and young adults (AYA).

Objective and method: We aimed to evaluate a consecutive series of patients treated at the State Institute of Hematology of Rio de Janeiro between 2012 and 2020, focusing on the AYA subgroup.

Result: The B-ALL was the most frequent subtype (81.6%) and AYA, the predominant age group (57.7%). The median overall survival (OS) was 9.4 months. High early mortality was observed and sepsis was the main cause of death. Better OS results were noted in AYA, in comparison to over 39y (13.3 × 6.2 months, respectively), the Berlin-Frankfurt-Münster (BFM) being the protocol of choice in this group.

Conclusion: The use of the pediatric protocol seems to improve the OS of AYA, however, high rates of deaths from infection were observed, demonstrating the need for advances in the Brazilian public system clinical support.

Keywords: Acute lymphoblastic leukemia; Adolescents and young adults; Latin America; Survival.

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Conflict of interest statement

Conflicts of interest None.

Figures

Figure 1
Figure 1
Frequency of the most common copy number alterations according to age. Forty-seven patients were investigated for the presence of CNAs by MLPA assays P335 and P202 and Multiplex PCR. The genes analyzed in these techniques are plotted on the X-axis, CDKN2A/B, PAX5, JAK2, PAR1 region, BTG1, EBF1, ETV6, RB1, and IKZF1. Here, PAR1 was considered altered if two or more genes in this region were affected: CRLF2, IL3RA, CSF2RA, P2RY8 and SHOX. The percentage of alteration frequency, loss or amplification in each gene is plotted on the Y-axis. The light gray bars represent the AYA group (age 15 - 39 years) and the dark gray, patients aged over 39 years.
Figure 2
Figure 2
Overall survival analysis of ALL patients. (A) Overall survival (OS) of all patients included in this study. (B) Comparison of OS according to age group and (C) leukemia subtype. P-values were calculated by the Log-rank method.
See this image and copyright information in PMC

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