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oai:recercat.cat:11351/77652025-10-24T10:42:51Zcom_2072_378070com_2072_378040col_2072_378092

Superior survival with pediatric-style chemotherapy compared to myeloablative allogeneic hematopoietic cell transplantation in older adolescents and young adults with Ph-negative acute lymphoblastic leukemia in first complete remission: analysis from CALGB 10403 and the CIBMTR Wieduwilt, Matthew stock, wendy Advani, Anjali Luger, Selina Larson, Richard Tallman, Martin Barba Suñol, Pere Institut Català de la Salut [Wieduwilt MJ] University of California, San Diego Medical Center, La Jolla, CA, USA. [Stock W, Larson RA] University of Chicago Medicine, Chicago, IL, USA. [Advani A] Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA. [Luger S] Abramson Cancer Center, University of Pennsylvania Medical Center, Philadelphia, PA, USA. [Tallman M] Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA. [Barba P] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain Vall d'Hebron Barcelona Hospital Campus Leucèmia limfoblàstica - Quimioteràpia Medicaments antineoplàstics - Ús terapèutic Avaluació de resultats (Assistència sanitària) DISEASES::Neoplasms::Neoplasms by Histologic Type::Leukemia::Leukemia, Lymphoid::Precursor Cell Lymphoblastic Leukemia-Lymphoma Other subheadings::Other subheadings::Other subheadings::/drug therapy CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome::Disease-Free Survival ENFERMEDADES::neoplasias::neoplasias por tipo histológico::leucemia::leucemia linfoide::leucemia-linfoma linfoblástico de células precursoras Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antineoplásicos TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento::supervivencia sin enfermedad Acute lymphocytic leukaemia; Chemotherapy Leucemia linfocítica aguda; Quimioterapia Leucèmia limfocítica aguda; Quimioteràpia Optimal post-remission therapy for adolescents and young adults (AYAs) with Ph-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1) is not established. We compared overall survival (OS), disease-free survival (DFS), relapse, and non-relapse mortality (NRM) for patients receiving post-remission therapy on CALGB 10403 to a cohort undergoing myeloablative (MA) allogeneic hematopoietic cell transplantation (HCT) in CR1. In univariate analysis, OS was superior with chemotherapy compared to MA allogeneic HCT (3-year OS 77% vs. 53%, P < 0.001). In multivariate analysis, allogeneic HCT showed inferior OS (HR 2.00, 95% CI 1.5–2.66, P < 0.001), inferior DFS (HR 1.62, 95% CI 1.25–2.12, P < 0.001), and increased NRM (HR 5.41, 95% CI 3.23–9.06, P < 0.001) compared to chemotherapy. A higher 5-year relapse incidence was seen with chemotherapy compared to allogeneic HCT (34% vs. 23%, P = 0.011). Obesity was independently associated with inferior OS (HR 2.17, 95% CI 1.63–2.89, P < 0.001), inferior DFS (HR 1.97, 95% CI 1.51–2.57, P < 0.001), increased relapse (1.84, 95% CI 1.31–2.59, P < 0.001), and increased NRM (HR 2.10, 95% CI 1.37–3.23, P < 0.001). For AYA ALL patients in CR1, post-remission therapy with pediatric-style chemotherapy is superior to MA allogeneic HCT for OS, DFS, and NRM. 2022-06-30T06:33:58Z 2022-06-30T06:33:58Z 2021-07 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Wieduwilt MJ, Stock W, Advani A, Luger S, Larson RA, Tallman M, et al. Superior survival with pediatric-style chemotherapy compared to myeloablative allogeneic hematopoietic cell transplantation in older adolescents and young adults with Ph-negative acute lymphoblastic leukemia in first complete remission: analysis from CALG. Leukemia. 2021 Jul;35(7):2076–2085. 1476-5551 https://hdl.handle.net/11351/7765 10.1038/s41375-021-01213-5 33785862 000635036100001 http://hdl.handle.net/11351/7765 eng Leukemia;35(7) https://doi.org/10.1038/s41375-021-01213-5 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf application/pdf application/pdf Springer Scientia