Improved survival in adolescents and young adults (AYA) patients aged 14–55 years with acute lymphoblastic leukemia using pediatric-inspired protocol – a retrospective analysis of a real-world experience in 79 of patients treated at a national tertiary care referral center

• Published in: Leukemia research reports 2021-01, Vol.16, p.100270-100270, Article 100270
• Main Authors: Hanbali, Amr, Kotb, Ahmed, Fakih, Riad El, Alfraih, Feras, Ahmed, Syed Osman, Shaheen, Marwan, Alhayli, Saud, Alahmari, Ali, Alotaibi, Ahmad, Alshaibani, Alfadel, Riash, Mahmoud Abu, Deeba, Farah, Asif, Maryam, Rasheed, Walid, Alzahrani, Hazzaa, Alsharif, Fahad, Chaudhri, Naeem, Almohareb, Fahad, Aljurf, Mahmoud
• Format: Article
• Language: English
• Subjects: Acute lymphoblastic leukemia; Adolescents and young adults; Pediatric-inspired protocol
• ISSN: 2213-0489; 2213-0489
• DOI: 10.1016/j.lrr.2021.100270

Treating adolescents and young adults (AYA) patients with acute lymphoblastic leukemia (ALL) using pediatric-inspired protocols have shown improvement in outcomes. Most data available in the literature of such protocols is derived from well-controlled clinical trials. This report aims to provide a real-world experience from using a pediatric-inspired protocol in ALL-AYA population in larger number of patients treated at a national tertiary care referral center. Newly diagnosed Philadelphia negative ALL-AYA patients ages between 14 and 55 years of age were treated on an institutional protocol (AYA-15 protocol) adopted from a modified version of Children's Cancer Group (CCG) 1900 protocol. At the time of this publication, a total of 79 patients were treated using the AYA-15 protocol between 2015 and 2020). Event-free survival (FFS), disease-free survival (DFS), and overall survival (OS) were analyzed using cumulative incidence and Kaplan-Meier methods. The median age at diagnosis was 18 years (14–51 years) with 63% male patients. Complete remission (CR) at day 28 of induction was achieved in 88.6% of which 73.4% were minimal residual disease (MRD) negative. At a median follow up of 5 years, EFS, DFS and OS were 57.5%, 69.2% and 75.8% respectively. Toxicities were within the expected range with infections and transaminitis being the most common adverse events. Our single-center experience real-world data in treating AYA-ALL patients with pediatric-inspired protocol demonstrates encouraging results of high survival rate and excellent tolerability for patients aged 18–55 years.