Prognostic Factors in a Multicenter Study for Treatment of Acute Lymphoblastic Leukemia in Adults

• Published in: Blood 1988-01, Vol.71 (1), p.123-131
• Main Authors: Hoelzer, D., Thiel, E., Loffler, H., Buchner, T., Ganser, A., Heil, G., Koch, P., Freund, M., Diedrich, H., Ruhl, H., Maschmeyer, G., Lipp, T., Nowrousian, M.R., Burkert, M., Gerecke, D., Pralle, H., Muller, U., Lunscken, Ch, Fulle, H., Ho, A.D., Kuchler, R., Busch, F.W., Schneider, W., Gorg, Ch, Emmerich, B., Braumann, D., Vaupel, H.A., Paleske, A. von, Bartels, H., Neiss, A., Messerer, D.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Antigens, Neoplasm - analysis; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Female; Hematologic and hematopoietic diseases; Humans; Leukemia, Lymphoid - blood; Leukemia, Lymphoid - drug therapy; Leukemia, Lymphoid - pathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Leukocyte Count; Male; Medical sciences; Middle Aged; Prognosis; Remission Induction
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V71.1.123.123

In a prospective multicenter study, 368 acute lymphoblastic leukemia (ALL) patients aged 15 to 65 years were treated with an intensified induction and reinduction regimen; 272 (73.9%) achieved complete remission (CR). The median remission duration (MRD) is 24.3 months, and the probability of being in continuous CR (CCR) at >5 years is .37. The median survival for all 368 patients is 27.5 months, and the probability of being alive at 5 years is .39. For the 272 patients in remission the median survival is 58.4 months, and the probability of being alive at 5 years is .49. A lower CR rate was seen for patients with bleeding at diagnosis or with splenomegaly/hepatosplenomegaly. The prognostic factors unfavorable for remission duration were time to CR >4 weeks v 35 years v 30,000/ μL v 5 years is .55; for c-ALL, .34; and for null ALL, .24. According to these results, patients were stratified into a low-risk group with a CCR rate of .62 and a high-risk group with a CCR rate of .28, with the latter now allocated to either further chemotherapy or bone marrow transplantation in first remission.