关键词: Acute lymphoblastic leukemia Hyper-CVAD PETHEMA ALL-93 Side effects Survival

Mesh : Adolescent Adult Antineoplastic Combined Chemotherapy Protocols / adverse effects therapeutic use Asparaginase / adverse effects therapeutic use Bacterial Infections / etiology Cyclophosphamide / adverse effects therapeutic use Dexamethasone / adverse effects therapeutic use Disease-Free Survival Doxorubicin / adverse effects therapeutic use Female Fever / etiology Humans Male Mercaptopurine / adverse effects therapeutic use Methotrexate / adverse effects therapeutic use Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy mortality Prednisone / adverse effects therapeutic use Retrospective Studies Survival Rate Treatment Outcome Vincristine / adverse effects therapeutic use Young Adult

来  源:   DOI:10.1159/000492531   PDF(Sci-hub)

Abstract:
BACKGROUND: Although cure rates in pediatric acute lymphoblastic leukemia (ALL) are quite high with combined chemotherapy regimens, complete response (CR) and long-term survival rates in adults are 80-90 and 30-40%, respectively. Currently, combined chemotherapy regimens, such as Hyper-CVAD and PETHEMA, are used in patients with adult ALL. However, there has been no study comparing the results of Hyper-CVAD and PETHEMA ALL-93.
METHODS: In this retrospective single-center study, we evaluated the results of Hyper-CVAD and PETHEMA ALL-93 in 51 ALL patients treated between September 2008 and March 2017 at the Department of Hematology, Faculty of Medicine, Karadeniz Technical University.
RESULTS: Thirty-eight patients were treated with Hyper-CVAD and 13 with PETHEMA ALL-93. CR was obtained in 90 and 100% of patients, respectively. Survival estimates were comparable between Hyper-CVAD and PE-THEMA ALL-93, with a median overall survival (OS) and a median disease-free survival (DFS) of 17.5 and 12.1 months, respectively, for Hyper-CVAD and of 18.6 and 12.9 months, respectively, for PETHEMA ALL-93. The 2-year OS rates for Hyper-CVAD and PETHEMA ALL-93 were 30 and 40%, respectively, and the 2-year DFS rates were 28 and 44%, respectively. PETHEMA ALL-93 resulted in more hepatotoxicity, hypofibrinogenemia, aspergillus infection, and skin rash than Hyper-CVAD.
CONCLUSIONS: Although Hyper-CVAD and PE-THEMA ALL-93 showed similar effects, Hyper-CVAD was tolerated better. Age and comorbidities should be taken into account before a chemotherapy regimen is determined for patients with ALL.
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