Pediatric-inspired regimen with late intensification and increased dose of L-asparaginase for adult acute lymphoblastic leukemia: the KALLA 1406/1407 study

Background/Aims The objective of this study was to evaluate the efficacy and feasibility of the pediatric-inspired regimen of the adult acute lymphoblastic leukemia (ALL) Working Party, the Korean Society of Hematology. Methods Data of 99 patients with newly diagnosed ALL, who were treated with the...

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Autores principales:	Dong Won Baek, Dae Young Kim, Sang Kyun Sohn, Youngil Koh, Sung-Hoon Jung, Ho-Young Yhim, Yunsuk Choi, Joon Ho Moon
Formato:	article
Lenguaje:	EN
Publicado:	The Korean Association of Internal Medicine 2021
Materias:	precursor cell lymphoblastic leukemia-lymphoma drug therapy asparaginase stem cell transplantation Medicine R
Acceso en línea:	https://doaj.org/article/1c4a497efbda41f882c1d6d53154e8b2
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spelling	oai:doaj.org-article:1c4a497efbda41f882c1d6d53154e8b22021-11-08T00:59:06ZPediatric-inspired regimen with late intensification and increased dose of L-asparaginase for adult acute lymphoblastic leukemia: the KALLA 1406/1407 study1226-33032005-664810.3904/kjim.2021.028https://doaj.org/article/1c4a497efbda41f882c1d6d53154e8b22021-11-01T00:00:00Zhttp://www.kjim.org/upload/pdf/kjim-2021-028.pdfhttps://doaj.org/toc/1226-3303https://doaj.org/toc/2005-6648Background/Aims The objective of this study was to evaluate the efficacy and feasibility of the pediatric-inspired regimen of the adult acute lymphoblastic leukemia (ALL) Working Party, the Korean Society of Hematology. Methods Data of 99 patients with newly diagnosed ALL, who were treated with the KALLA 1406/1407 protocol, were retrospectively analyzed. All patients equally received age-adjusted daunorubicin, vincristine, and prednisolone. L-asparaginase was additionally administered to Philadelphia (Ph)-negative patients according to age, whereas Ph-positive patients received 600 mg/day of imatinib. Results A total of 99 patients were enrolled in this study, of whom 62 (62.6%) were diagnosed with Ph-negative ALL and 37 (37.3%) were diagnosed with Ph-positive ALL. The median age of patients in the Ph-negative ALL group was 46 years, and that of patients in the Ph-positive ALL group was 49 years. In patients with Ph-negative ALL, 57 (92%) patients achieved complete remission (CR) and CR with incomplete hematologic recovery (CRi). Disease-free survival (DFS) and overall survival (OS) rates at 2 years were estimated to be 42% and 63%, respectively. In patients with Ph-positive ALL, 32 (86%) patients achieved CR/CRi, and 2-year DFS and OS were 31.2% and 49.1%, respectively. Patients who were able to proceed to the allogeneic hematopoietic cell transplantation and younger patients showed significantly superior survival in both Ph-negative ALL and Ph-positive ALL. Neutropenic fever and bacterial infection were the most common and severe adverse events. Conclusions The KALLA 1406/1407 protocol showed tolerable toxicities in adult ALL patients. Especially, younger patients had more survival benefits with KALLA 1406/1407 protocol.Dong Won BaekDae Young KimSang Kyun SohnYoungil KohSung-Hoon JungHo-Young YhimYunsuk ChoiJoon Ho MoonThe Korean Association of Internal Medicinearticleprecursor cell lymphoblastic leukemia-lymphomadrug therapyasparaginasestem cell transplantationMedicineRENThe Korean Journal of Internal Medicine, Vol 36, Iss 6, Pp 1471-1485 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	precursor cell lymphoblastic leukemia-lymphoma drug therapy asparaginase stem cell transplantation Medicine R
spellingShingle	precursor cell lymphoblastic leukemia-lymphoma drug therapy asparaginase stem cell transplantation Medicine R Dong Won Baek Dae Young Kim Sang Kyun Sohn Youngil Koh Sung-Hoon Jung Ho-Young Yhim Yunsuk Choi Joon Ho Moon Pediatric-inspired regimen with late intensification and increased dose of L-asparaginase for adult acute lymphoblastic leukemia: the KALLA 1406/1407 study
description	Background/Aims The objective of this study was to evaluate the efficacy and feasibility of the pediatric-inspired regimen of the adult acute lymphoblastic leukemia (ALL) Working Party, the Korean Society of Hematology. Methods Data of 99 patients with newly diagnosed ALL, who were treated with the KALLA 1406/1407 protocol, were retrospectively analyzed. All patients equally received age-adjusted daunorubicin, vincristine, and prednisolone. L-asparaginase was additionally administered to Philadelphia (Ph)-negative patients according to age, whereas Ph-positive patients received 600 mg/day of imatinib. Results A total of 99 patients were enrolled in this study, of whom 62 (62.6%) were diagnosed with Ph-negative ALL and 37 (37.3%) were diagnosed with Ph-positive ALL. The median age of patients in the Ph-negative ALL group was 46 years, and that of patients in the Ph-positive ALL group was 49 years. In patients with Ph-negative ALL, 57 (92%) patients achieved complete remission (CR) and CR with incomplete hematologic recovery (CRi). Disease-free survival (DFS) and overall survival (OS) rates at 2 years were estimated to be 42% and 63%, respectively. In patients with Ph-positive ALL, 32 (86%) patients achieved CR/CRi, and 2-year DFS and OS were 31.2% and 49.1%, respectively. Patients who were able to proceed to the allogeneic hematopoietic cell transplantation and younger patients showed significantly superior survival in both Ph-negative ALL and Ph-positive ALL. Neutropenic fever and bacterial infection were the most common and severe adverse events. Conclusions The KALLA 1406/1407 protocol showed tolerable toxicities in adult ALL patients. Especially, younger patients had more survival benefits with KALLA 1406/1407 protocol.
format	article
author	Dong Won Baek Dae Young Kim Sang Kyun Sohn Youngil Koh Sung-Hoon Jung Ho-Young Yhim Yunsuk Choi Joon Ho Moon
author_facet	Dong Won Baek Dae Young Kim Sang Kyun Sohn Youngil Koh Sung-Hoon Jung Ho-Young Yhim Yunsuk Choi Joon Ho Moon
author_sort	Dong Won Baek
title	Pediatric-inspired regimen with late intensification and increased dose of L-asparaginase for adult acute lymphoblastic leukemia: the KALLA 1406/1407 study
title_short	Pediatric-inspired regimen with late intensification and increased dose of L-asparaginase for adult acute lymphoblastic leukemia: the KALLA 1406/1407 study
title_full	Pediatric-inspired regimen with late intensification and increased dose of L-asparaginase for adult acute lymphoblastic leukemia: the KALLA 1406/1407 study
title_fullStr	Pediatric-inspired regimen with late intensification and increased dose of L-asparaginase for adult acute lymphoblastic leukemia: the KALLA 1406/1407 study
title_full_unstemmed	Pediatric-inspired regimen with late intensification and increased dose of L-asparaginase for adult acute lymphoblastic leukemia: the KALLA 1406/1407 study
title_sort	pediatric-inspired regimen with late intensification and increased dose of l-asparaginase for adult acute lymphoblastic leukemia: the kalla 1406/1407 study
publisher	The Korean Association of Internal Medicine
publishDate	2021
url	https://doaj.org/article/1c4a497efbda41f882c1d6d53154e8b2
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Pediatric-inspired regimen with late intensification and increased dose of L-asparaginase for adult acute lymphoblastic leukemia: the KALLA 1406/1407 study

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