Final results of a single institution experience with a pediatric-based regimen, the augmented Berlin-Frankfurt-Münster, in adolescents and young adults with acute lymphoblastic leukemia, and comparison to the hyper-CVAD regimen

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• 作者：Michael E. Rytting ; Elias J. Jabbour ; Jeffrey L. Jorgensen ; Farhad Ravandi ; Anna R. Franklin ; Tapan M. Kadia ; Naveen Pemmaraju ; Naval G. Daver ; Alessandra Ferrajoli ; Guillermo Garcia-Manero ; Marina Y. Konopleva ; Gautam Borthakur ; Rebecca Garris ; Sa Wang ; Sherry Pierce ; Kurt Schroeder ; Steven M. Kornblau ; Deborah A. Thomas ; Jorge E. Cortes ; Susan M. O' ; Brien and Hagop M. Kantarjian
• 刊名：American Journal of Hematology
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：91
• 期：8
• 页码：819-823
• 全文大小：537K
• ISSN：1096-8652

文摘

Several studies reported improved outcomes of adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) treated with pediatric-based ALL regimens. This prompted the prospective investigation of a pediatric Augmented Berlin–Frankfurt–Münster (ABFM) regimen, and its comparison with hyper-fractionated cyclophosphamide, vincristine, Adriamycin, and dexamethasone (hyper-CVAD) in AYA patients. One hundred and six AYA patients (median age 22 years) with Philadelphia chromosome- (Ph) negative ALL received ABFM from October 2006 through March 2014. Their outcome was compared to 102 AYA patients (median age 27 years), treated with hyper-CVAD at our institution. The complete remission (CR) rate was 93% with ABFM and 98% with hyper-CVAD. The 5-year complete remission duration (CRD) were 53 and 55%, respectively (m>Pm> = 0.98). The 5-year overall survival (OS) rates were 60 and 60%, respectively. The MRD status on Day 29 and Day 84 of therapy was predictive of long-term outcomes on both ABFM and hyper-CVAD. Severe regimen toxicities with ABFM included hepatotoxicity in 41%, pancreatitis in 11%, osteonecrosis in 9%, and thrombosis in 19%. Myelosuppression-associated complications were most significant with hyper-CVAD. In summary, ABFM and hyper-CVAD resulted in similar efficacy outcomes, but were associated with different toxicity profiles, asparaginase-related with ABFM and myelosuppression-related with hyper-CVAD. Am. J. Hematol. 91:819–823, 2016.