ALL-394: Hyper-CVAD vs. BFM-Like Regimens in Adult Patients with Philadelphia-Negative Acute Lymphoblastic Leukemia: A Single-Center Experience

Abstract

Context Acute lymphoblastic leukemia (ALL) is a heterogeneous group of diseases characterized by clonal proliferation of lymphoblasts. Improvement in the outcome of ALL in adult patients still has unfulfilled needs. Objective This study was conducted to compare outcome of the polychemotherapy regimens BFM-like chemotherapy and hyperCVAD in adult ALL patients. Design Retrospective study applied to 77 adult ALL patients who were diagnosed between 2011 and January 2019. Setting The study was conducted at Oncology Center Mansoura University. Patients or other participants Study applied to 77 adult Philadelphia-negative ALL patients: 49 (63.6%) patients were male and 28 (36.4%) patients were female, with a mean age of 28 years (range: 16–60). Interventions The study consisted of 2 arms for polychemotherapy regimens; BFM-like and hyper-CVAD. Main outcome measures Complete response (CR) rate and overall survival (OS). Results Among the 77 patients that were included, 48 patients (62.3%) had B-cell ALL, and 29 patients (37.7%) had T-cell ALL. Fifty-one patients (66.2%) were treated by BFM-like chemotherapy, and 26 patients (33.8%) were treated by hyper-CVAD. Complete remission rate was 90.2% and 73.1% in BFM-like chemotherapy and hyper-CVAD, respectively (p=0.05). There was no statistically significant difference in relapse rate between both regimens. Both regimens were comparable regarding different toxicities, ICU admission rate, and therapy-related deaths. Patients who received BFM-like chemotherapy showed a significant OS than who received hyper-CVAD (median; 28 vs. 12 month p=0.008). Moreover, in subset analysis; younger patients ( Conclusions A BFM-like regimen appears to be appropriate for young adult patients with ALL. Both BFM-like regimen and hyper CVAD seem to be equally safe and effective in adult patients ≥ 30 years.