Abstract
Young adults with acute lymphoblastic leukemia do better when treated on "pediatric" protocols. Young adults (18-30years) with Ph-negative ALL treated between 2000 and 2014 were retrospectively analyzed. Two-hundred and thirty-two patients were included [median age 21years (18-30); 176 (76%) males; median WBC 16,000/cmm]. Protocols used were: BFM 95 (N=147, 63%), MCP-841 (N=51, 22%), GMALL (N=21, 9%), INCTR (N=9, 4%) and UKALL (N=4, 2%). Complete remission was achieved in 194/232 (84%). Twenty patients (9%) died due to toxicity which was higher with BFM versus others (18/147 vs. 2/85; p=0.031). After a median follow-up of 48months, median RFS and OS were 35.5months (25-46), and 25months (18-31) and actuarial RFS and OS (5-years) were 45% (37-53) and 39% (32-46). BFM protocol improved RFS (51 vs. 35%, p=0.027) but not OS (43 vs. 33%, p=0.2). The survival outcomes reported are 15-20% lower than those reported from West. Better supportive care and risk-adapted therapy may improve outcomes.
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