Acute lymphoblastic leukemia in young adults: Two chemotherapeutic protocols for the treatment of 46 patients

Ching Liang Ho, Yeu Chin Chen, Wei You Kao, Tsu Yi Chao

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background. Acute lymphoblastic leukemia (ALL) in adults has a very poor prognosis. Many chemotherapeutic protocols have been designed to try to improve treatment results for adult ALL. Two chemotherapeutic protocols were used to treat young adult ALL patients in our institute and treatment results are reported. Methods. From 1984 through 1997, 46 young adult patients with ALL were treated. There were 43 males and three females. Their ages ranged from 16 to 38 years, with a median of 24 years. Thirty-two patients (group A) received a four-week conventional induction regimen with daunomycin, vincristine, prednisolone, and L-asparaginase, followed by prophylaxis of the central nervous system (CNS) with intrathecal methotrexate and cranial irradiation, as well as maintenance therapy with oral 6-mercaptopurine and methotrexate. Fourteen patients (group B) received the modified protocol of the German multicenter trial for adult ALL (GMALL) with a two-phase induction regimen, CNS prophylaxis and maintenance therapy. Results. In group A, 25 of 32 patients achieved complete remission (CR), three obtained partial remission and four died of treatment-related complications during induction therapy. The median duration of remission (DR) was 12 months (range, 3-39 months) and the median overall survival time (OST) was 13 months (range, 0.5- 50 months). Of the 25 patients who achieved CR, 21 relapsed and died. In group B, 11 of 14 patients obtained CR and three died of leukopenia-related infectious complications during induction. The median DR was 12 months (range, 8-37 months) and the median OST was 15 months (range, 0.5-39 months). During follow-up, 10 of 11 patients relapsed from ALL and died. Only one patient who received allogeneic bone marrow transplantation first CR is still alive. No statistical differences between the two groups were noted in terms of CR rate, DR (p = 0.87) and OST (p = 0.34). However, the the GMALL protocol had during the significantly more hematologic toxicity during induction therapy. Conclusions. Our results suggest that young adult ALL is a disease with a very poor prognosis and conventional chemotherapy is not adequate for its treatment. The notion that GMALL protocol is better than conventional therapy in the treatment of adult ALL cannot be justified by our data.

Original languageEnglish
Pages (from-to)45-52
Number of pages8
JournalChinese Medical Journal (Taipei)
Volume63
Issue number1
Publication statusPublished - Jan 2000
Externally publishedYes

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Clinical Protocols
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Young Adult
Multicenter Studies
Therapeutics
Methotrexate
Survival
Central Nervous System
Cranial Irradiation
Asparaginase
6-Mercaptopurine
Daunorubicin
Homologous Transplantation
Leukopenia
Vincristine
Prednisolone
Bone Marrow Transplantation
Drug Therapy

Keywords

  • Acute lymphoblastic leukemia
  • GMALL protocol
  • Remission
  • Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Acute lymphoblastic leukemia in young adults : Two chemotherapeutic protocols for the treatment of 46 patients. / Ho, Ching Liang; Chen, Yeu Chin; Kao, Wei You; Chao, Tsu Yi.

In: Chinese Medical Journal (Taipei), Vol. 63, No. 1, 01.2000, p. 45-52.

Research output: Contribution to journalArticle

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abstract = "Background. Acute lymphoblastic leukemia (ALL) in adults has a very poor prognosis. Many chemotherapeutic protocols have been designed to try to improve treatment results for adult ALL. Two chemotherapeutic protocols were used to treat young adult ALL patients in our institute and treatment results are reported. Methods. From 1984 through 1997, 46 young adult patients with ALL were treated. There were 43 males and three females. Their ages ranged from 16 to 38 years, with a median of 24 years. Thirty-two patients (group A) received a four-week conventional induction regimen with daunomycin, vincristine, prednisolone, and L-asparaginase, followed by prophylaxis of the central nervous system (CNS) with intrathecal methotrexate and cranial irradiation, as well as maintenance therapy with oral 6-mercaptopurine and methotrexate. Fourteen patients (group B) received the modified protocol of the German multicenter trial for adult ALL (GMALL) with a two-phase induction regimen, CNS prophylaxis and maintenance therapy. Results. In group A, 25 of 32 patients achieved complete remission (CR), three obtained partial remission and four died of treatment-related complications during induction therapy. The median duration of remission (DR) was 12 months (range, 3-39 months) and the median overall survival time (OST) was 13 months (range, 0.5- 50 months). Of the 25 patients who achieved CR, 21 relapsed and died. In group B, 11 of 14 patients obtained CR and three died of leukopenia-related infectious complications during induction. The median DR was 12 months (range, 8-37 months) and the median OST was 15 months (range, 0.5-39 months). During follow-up, 10 of 11 patients relapsed from ALL and died. Only one patient who received allogeneic bone marrow transplantation first CR is still alive. No statistical differences between the two groups were noted in terms of CR rate, DR (p = 0.87) and OST (p = 0.34). However, the the GMALL protocol had during the significantly more hematologic toxicity during induction therapy. Conclusions. Our results suggest that young adult ALL is a disease with a very poor prognosis and conventional chemotherapy is not adequate for its treatment. The notion that GMALL protocol is better than conventional therapy in the treatment of adult ALL cannot be justified by our data.",
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T2 - Two chemotherapeutic protocols for the treatment of 46 patients

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AU - Kao, Wei You

AU - Chao, Tsu Yi

PY - 2000/1

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N2 - Background. Acute lymphoblastic leukemia (ALL) in adults has a very poor prognosis. Many chemotherapeutic protocols have been designed to try to improve treatment results for adult ALL. Two chemotherapeutic protocols were used to treat young adult ALL patients in our institute and treatment results are reported. Methods. From 1984 through 1997, 46 young adult patients with ALL were treated. There were 43 males and three females. Their ages ranged from 16 to 38 years, with a median of 24 years. Thirty-two patients (group A) received a four-week conventional induction regimen with daunomycin, vincristine, prednisolone, and L-asparaginase, followed by prophylaxis of the central nervous system (CNS) with intrathecal methotrexate and cranial irradiation, as well as maintenance therapy with oral 6-mercaptopurine and methotrexate. Fourteen patients (group B) received the modified protocol of the German multicenter trial for adult ALL (GMALL) with a two-phase induction regimen, CNS prophylaxis and maintenance therapy. Results. In group A, 25 of 32 patients achieved complete remission (CR), three obtained partial remission and four died of treatment-related complications during induction therapy. The median duration of remission (DR) was 12 months (range, 3-39 months) and the median overall survival time (OST) was 13 months (range, 0.5- 50 months). Of the 25 patients who achieved CR, 21 relapsed and died. In group B, 11 of 14 patients obtained CR and three died of leukopenia-related infectious complications during induction. The median DR was 12 months (range, 8-37 months) and the median OST was 15 months (range, 0.5-39 months). During follow-up, 10 of 11 patients relapsed from ALL and died. Only one patient who received allogeneic bone marrow transplantation first CR is still alive. No statistical differences between the two groups were noted in terms of CR rate, DR (p = 0.87) and OST (p = 0.34). However, the the GMALL protocol had during the significantly more hematologic toxicity during induction therapy. Conclusions. Our results suggest that young adult ALL is a disease with a very poor prognosis and conventional chemotherapy is not adequate for its treatment. The notion that GMALL protocol is better than conventional therapy in the treatment of adult ALL cannot be justified by our data.

AB - Background. Acute lymphoblastic leukemia (ALL) in adults has a very poor prognosis. Many chemotherapeutic protocols have been designed to try to improve treatment results for adult ALL. Two chemotherapeutic protocols were used to treat young adult ALL patients in our institute and treatment results are reported. Methods. From 1984 through 1997, 46 young adult patients with ALL were treated. There were 43 males and three females. Their ages ranged from 16 to 38 years, with a median of 24 years. Thirty-two patients (group A) received a four-week conventional induction regimen with daunomycin, vincristine, prednisolone, and L-asparaginase, followed by prophylaxis of the central nervous system (CNS) with intrathecal methotrexate and cranial irradiation, as well as maintenance therapy with oral 6-mercaptopurine and methotrexate. Fourteen patients (group B) received the modified protocol of the German multicenter trial for adult ALL (GMALL) with a two-phase induction regimen, CNS prophylaxis and maintenance therapy. Results. In group A, 25 of 32 patients achieved complete remission (CR), three obtained partial remission and four died of treatment-related complications during induction therapy. The median duration of remission (DR) was 12 months (range, 3-39 months) and the median overall survival time (OST) was 13 months (range, 0.5- 50 months). Of the 25 patients who achieved CR, 21 relapsed and died. In group B, 11 of 14 patients obtained CR and three died of leukopenia-related infectious complications during induction. The median DR was 12 months (range, 8-37 months) and the median OST was 15 months (range, 0.5-39 months). During follow-up, 10 of 11 patients relapsed from ALL and died. Only one patient who received allogeneic bone marrow transplantation first CR is still alive. No statistical differences between the two groups were noted in terms of CR rate, DR (p = 0.87) and OST (p = 0.34). However, the the GMALL protocol had during the significantly more hematologic toxicity during induction therapy. Conclusions. Our results suggest that young adult ALL is a disease with a very poor prognosis and conventional chemotherapy is not adequate for its treatment. The notion that GMALL protocol is better than conventional therapy in the treatment of adult ALL cannot be justified by our data.

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KW - Remission

KW - Survival

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