Outcome of patients with adult acute lymphoblastic leukemia between 2000 and 2013: experience from single center.
- Author:
Jing WANG
1
;
Bin JIANG
1
;
Kaiyan LIU
1
;
Lanping XU
1
;
Xiaohui ZHANG
1
;
Huan CHEN
1
;
Jinsong JIA
1
;
Shenmiao YANG
1
;
Li BAO
1
;
Hao JIANG
1
;
Jin LU
1
;
Honghu ZHU
1
;
Ting ZHAO
1
;
Xiaojun HUANG
1
;
Qian JIANG
1
Author Information
- Publication Type:Journal Article
- MeSH: Acute Disease; Adult; Disease-Free Survival; Hematopoietic Stem Cell Transplantation; Humans; Imatinib Mesylate; therapeutic use; Induction Chemotherapy; Multivariate Analysis; Precursor Cell Lymphoblastic Leukemia-Lymphoma; therapy; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma; therapy; Recurrence; Remission Induction; Retrospective Studies; Survival Rate
- From: Chinese Journal of Hematology 2015;36(9):726-732
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo compare the outcomes of patients with adult acute lymphoblastic leukemia (ALL) over the last 14 years by taking 2006 as the demarcation point.
METHODSFrom January 2000 to December 2013, 477 consecutive hospitalized patients with adult ALL were retrospectively analyzed, including 276 (57.9%) with Ph negative B-ALL (Ph⁻-B-ALL) B-ALL, 69 (14.5%) with T-ALL and 132 (27.7%) with Ph positive ALL (Ph⁺-ALL); 111 (23.3%) before 2006 and 366 (76.7%) after 2006. Among 435 patients who achieved complete remission (CR), 248 (57.0%) received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and 187 remained on chemotherapy.
RESULTSWith a median follow-up period of 19 months in all patients and 35 months in living patients, overall CR rate was 92.0%. Of 435 CR patients, the cumulative incidences of 5-year relapse, disease-free survival( DFS) and overall survival (OS) rates were 42.5%, 46.2% and 47.6%, respectively. Compared with the patients hospitalized before 2006: ① the Ph+-ALL patients hospitalized after 2006 achieved a higher overall CR rate (P=0.036). There was no difference for CR rates of Ph--B-ALL and T-ALL patients between before and after 2006. ②The CR patients hospitalized after 2006 had higher 5-year DFS and OS rates (P=0.001; P < 0.001), including higher 5-year OS rate in Ph⁻-B-ALL patients (P=0.046), and higher 5-year DFS and OS rates in both T-ALL (P=0.013; P=0.036) and Ph⁺-ALL patients (P=0.003; P < 0.001) , especially in those Ph⁺-ALL patients who received imatinib from the beginning of the induction chemotherapy (P < 0.001; P < 0.001) ③The patients who received allo-HSCT after 2006 had higher 5-year DFS and OS rates (P=0.001; P < 0.001), but there was no difference for the outcomes in those who remained on chemotherapy before and after 2006. After 2006, Ph⁺-ALL patients who received imatinib from the beginning of the induction chemotherapy had the highest 5-year DFS and OS rates compared with Ph⁻-B-ALL and T-ALL patients (P=0.009; P=0.001) . Multivariate analysis showed that allo-HSCT and imatinib were two important factors affecting the outcomes of ALL patients.
CONCLUSIONThe outcomes of ALL patients improved significantly over the last 14 years, especially in Ph⁺-ALL ones.
