Role of early anthracycline dose-intensity according to expression of Philadelphia chromosome/BCR-ABL rearrangements in B-precursor adult acute lymphoblastic leukemia

The Hematology Journal : the Official Journal of the European Haematology Association
R BassanT Barbui

Abstract

The use of anthracycline antibiotics in adult acute lymphoblastic leukemia (ALL) has resulted in an improved outcome to remission induction therapy. However,the exact role of these drugs in consolidation therapy is less clear, especially in specific ALL subsets. A retrospective analysis was conducted on the outcome of 308 patients (median age 35 years, range 13-75) with the most frequent subtype, early-B ALL, treated between 1974 and 1998 on eight consecutive protocols. Anthracycline-related effects were assessed by evaluating the impact of planned anthracycline dose-intensity (A-DI) on long-term outcome. A-DI (in mg/m(2)/week) during the first twelve weeks of consolidation therapy was classified as either "high" (doxorubicin>20, idarubicin>7) or "low". Complete remission was achieved in 78% of cases. With a median follow-up of 6.5 years, on multivariate analysis, disease-free survival (DFS) correlated only with expression of the Philadelphia (Ph) chromosome and/or associated BCR-ABL rearrangements (Ph/BCR(+)) (P=0.0001) and planned A-DI (P<0.0001). On this basis, four major prognostic groups with significantly different DFS could be identified: (1) Ph/BCR(-), "high" A-DI (n=102), median 3.5 years and 41% at five years, respect...Continue Reading

Citations

Jul 8, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Renato BassanAlessandro Rambaldi
Mar 13, 2014·Expert Review of Anticancer Therapy·Elena MainoRenato Bassan
Apr 17, 2015·Blood·Yves ChalandonUNKNOWN Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL)
Oct 4, 2017·American Journal of Hematology·Riad El FakihHagop Kantarjian
Aug 9, 2005·Expert Opinion on Emerging Drugs·Xavier Thomas
Jun 9, 2004·Critical Reviews in Oncology/hematology·Renato BassanRoel Willemze

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