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oai:recercat.cat:2445/1743742025-12-05T12:10:08Zcom_2072_1057col_2072_478916col_2072_478917

A pediatric regimen for adolescents and young adults with Philadelphia chromosome‐negative acute lymphoblastic leukemia: Results of the ALLRE08 PETHEMA trial Ribera, Josep Maria Morgades, Mireia Montesinos, Pau Tormo, Mar Martínez Carballeira, Daniel González Campos, José Gil, Cristina Barba, Pere García Boyero, Raimundo Coll, Rosa Pedreño, María Ribera, Jordi Mercadal, Santiago Vives, Susana Novo, Andrés Genescà, Eulàlia Hernández Rivas, Jesús María Bergua, Juan Amigo, María Luz Vall Llovera, Ferran Martínez Sánchez, Pilar Calbacho, María García Cadenas, Irene Garcia Guiñon, Antonio Sánchez Sánchez, María José Cervera, Marta Feliu, Evarist Orfao, Alberto PETHEMA Group Leucèmia limfocítica crònica Adolescents Chronic lymphocytic leukemia Teenagers Background: Pediatric-based or -inspired trials have improved the prognosis of adolescents and young adults (AYA) with Philadelphia chromosome-negative (Ph-neg) acute lymphoblastic leukemia (ALL). Methods: This study reports the results of treatment of the ALLRE08 trial, a full pediatric trial for AYA aged 15-30 years with standard-risk (SR) ALL. Results: From 2008 to 2018, 89 patients (38 adolescents [15-18 years] and 51 young adults [YA, 19-30 years], median age: 20 [15-29] years) were enrolled in the ALLRE08 trial. The complete response (CR) was 95%. Twenty-two patients were transferred to a high-risk (HR) protocol because of poor marrow response on day 14 (n = 20) or high-level of end-induction minimal residual response (MRD ≥ 0.25%, n = 2). Cumulative incidence of relapse (CIR) at 5 years was 35% (95%CI: 23%-47%), with significant differences between adolescents and YA: 13% (4%-28%) vs 52% (34%-67%), P = .012. No treatment-related mortality was observed in 66/66 patients following the ALLRE08 trial vs 3/23 patients moved to a HR trial. The estimated 5-year overall survival (OS) was 74% (95%CI: 63%-85%), with significantly higher rates for adolescents vs YA: 87% (95%CI: 74%-100%) vs 63% (46%-80%), P = .021. Although CIR or OS were lower in patients who were transferred to a HR trial, the differences were not statistically significant (CIR: 34% [21%-47%] vs 37% [14%-61%]; OS: 78% [66%-90%] vs 61% [31%;91%]). Conclusion: A full pediatric trial is feasible and effective for AYA with Ph-neg, SR-ALL, with better results for adolescents than for YA. Outcome of patients with poor early response rescued with a HR trial was not significantly inferior. 2021-02-26T08:54:27Z 2021-02-26T08:54:27Z 2020-04-01 2021-02-16T12:17:09Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.1002/cam4.2814 Cancer Medicine, 2020, vol. 9, num. 7, p. 2317-2329 https://doi.org/10.1002/cam4.2814 cc by (c) Ribera et al., 2020 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess John Wiley & Sons Ltd. Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))