High relapse rate of T cell acute lymphoblastic leukemia in adults treated with Hyper-CVAD chemotherapy in Sweden
(2014) In European Journal of Haematology 92(5). p.377-381- Abstract
- Background Hyper-CVAD is widely used to treat acute lymphoblastic leukemia (ALL) and aggressive lymphomas. This multicenter, population-based study assessed the efficacy of Hyper-CVAD as first-line therapy in patients with T-cell ALL (T-ALL). Patients and methods Between October 2002 and September 2006, 24 patients were diagnosed with T-ALL in Sweden; 19 were eligible for treatment with the protocol. Results The median age was 32yr (range 18-72yr). Complete remission (CR) was obtained in 17 of 19 (89%) patients, and the treatment was relatively well tolerated. Allogeneic stem cell transplantation (SCT) was recommended in high-risk disease and was performed in four patients upfront. Two- and 5-yr leukemia-free survivals (LFS) in 17 patients... (More)
- Background Hyper-CVAD is widely used to treat acute lymphoblastic leukemia (ALL) and aggressive lymphomas. This multicenter, population-based study assessed the efficacy of Hyper-CVAD as first-line therapy in patients with T-cell ALL (T-ALL). Patients and methods Between October 2002 and September 2006, 24 patients were diagnosed with T-ALL in Sweden; 19 were eligible for treatment with the protocol. Results The median age was 32yr (range 18-72yr). Complete remission (CR) was obtained in 17 of 19 (89%) patients, and the treatment was relatively well tolerated. Allogeneic stem cell transplantation (SCT) was recommended in high-risk disease and was performed in four patients upfront. Two- and 5-yr leukemia-free survivals (LFS) in 17 patients with CR achievement were identical, at 29% (95% confidence interval [CI]: 8-51). Two- and 5-yr overall survival (OS) in whole cohort was 63% (95% CI: 42-85) and 47% (95% CI: 26-69), respectively. The 5-yr LFS for 15 patients who did not receive allogeneic SCT upfront were 20% (95% CI: 0-40), although 14 of 15 completed the protocol (eight cycles). Relapse occurred in 2 of 4 upfront-transplanted patients and in 12 of 15 patients treated with chemotherapy alone, six of whom received allogeneic SCT in CR2. Age >= 35yr influenced OS negatively in univariate analysis (HR 5.1, 95% CI: 1.55-16.7). Conclusions Hyper-CVAD treatment resulted in a high CR rate and appeared safe, but it showed poor efficacy at preventing relapse. Therefore, this treatment is no longer recommended for adults with T-ALL in Sweden. (Less)
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- author
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- antineoplastic combined chemotherapy protocols, treatment outcome, precursor T-cell lymphoblastic leukemia-lymphoma, stem cell, transplantation
- in
- European Journal of Haematology
- volume
- 92
- issue
- 5
- pages
- 377 - 381
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000334267500002
- scopus:84898801134
- pmid:24443846
- ISSN
- 1600-0609
- DOI
- 10.1111/ejh.12269
- language
- English
- LU publication?
- yes
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- 3b5a8885-dd91-4159-a389-0c85ce3dfaec (old id 4438856)
- date added to LUP
- 2016-04-01 10:18:13
- date last changed
- 2022-07-14 05:36:27
@article{3b5a8885-dd91-4159-a389-0c85ce3dfaec,
abstract = {{Background Hyper-CVAD is widely used to treat acute lymphoblastic leukemia (ALL) and aggressive lymphomas. This multicenter, population-based study assessed the efficacy of Hyper-CVAD as first-line therapy in patients with T-cell ALL (T-ALL). Patients and methods Between October 2002 and September 2006, 24 patients were diagnosed with T-ALL in Sweden; 19 were eligible for treatment with the protocol. Results The median age was 32yr (range 18-72yr). Complete remission (CR) was obtained in 17 of 19 (89%) patients, and the treatment was relatively well tolerated. Allogeneic stem cell transplantation (SCT) was recommended in high-risk disease and was performed in four patients upfront. Two- and 5-yr leukemia-free survivals (LFS) in 17 patients with CR achievement were identical, at 29% (95% confidence interval [CI]: 8-51). Two- and 5-yr overall survival (OS) in whole cohort was 63% (95% CI: 42-85) and 47% (95% CI: 26-69), respectively. The 5-yr LFS for 15 patients who did not receive allogeneic SCT upfront were 20% (95% CI: 0-40), although 14 of 15 completed the protocol (eight cycles). Relapse occurred in 2 of 4 upfront-transplanted patients and in 12 of 15 patients treated with chemotherapy alone, six of whom received allogeneic SCT in CR2. Age >= 35yr influenced OS negatively in univariate analysis (HR 5.1, 95% CI: 1.55-16.7). Conclusions Hyper-CVAD treatment resulted in a high CR rate and appeared safe, but it showed poor efficacy at preventing relapse. Therefore, this treatment is no longer recommended for adults with T-ALL in Sweden.}},
author = {{Kozlowski, Piotr and Astrom, Maria and Ahlberg, Lucia and Bernell, Per and Hulegardh, Erik and Hagglund, Hans and Karlsson, Karin and Markuszewska-Kuczymska, Alicja and Tomaszewska-Toporska, Beata and Smedmyr, Bengt and Amini, Rose-Marie and Hallbook, Helene}},
issn = {{1600-0609}},
keywords = {{antineoplastic combined chemotherapy protocols; treatment outcome; precursor T-cell lymphoblastic leukemia-lymphoma; stem cell; transplantation}},
language = {{eng}},
number = {{5}},
pages = {{377--381}},
publisher = {{Wiley-Blackwell}},
series = {{European Journal of Haematology}},
title = {{High relapse rate of T cell acute lymphoblastic leukemia in adults treated with Hyper-CVAD chemotherapy in Sweden}},
url = {{http://dx.doi.org/10.1111/ejh.12269}},
doi = {{10.1111/ejh.12269}},
volume = {{92}},
year = {{2014}},
}