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Haroon, Alfadil; Alfraih, Feras; Hanbali, Amr; Kotb, Ahmed; Somali, Zakiah Al; Bahkali, Fahad N; Alhayli, Saud; Madien, Heba Mahmoud; Ahmed, Syed Osman; Albabtain, Abdulwahab A; Shaheen, Marwan; Chaudhri, Naeem; Alsharif, Fahad; Alshaibani, Alfadel; Alotaibi, Ahmad S; Elhassan, Tusneem; Almohareb, Fahad; Alahmari, Ali; Rasheed, Walid; Alzahrani, Hazzaa; Aljurf, Mahmoud; El Fakih, Riad
Bone marrow transplantation (Basingstoke), 04/2022, Volume: 57, Issue: 4Journal Article
Pediatric-inspired non-transplant regimens for adolescent and adult ALL patients are becoming standard in many institutions. We aimed to compare a cohort of patients receiving a pediatric-inspired protocol to a cohort of patients treated with adult type ALL therapy followed by allografting after achieving CR1. Eighty-five adolescent and adult ALL patients treated with CALGB 19802 protocol who received MSD transplant in CR1 were retrospectively compared to a matched cohort of 72 adolescent and adult ALL patients treated with a modified version of Children's Cancer Group (CCG) 1900 protocol. The five years OS in the allo-HCT cohort was 63.1% compared to 80.2% in the pediatric-inspired chemotherapy arm (P = 0.03). The five years EFS in the allo-HCT arm was 58.8% compared to 61.6% in the pediatric-inspired chemotherapy arm (P = 0.07). The five years DFS in the allo-HCT arm was 58.8% as compared to 71.9% in the pediatric-inspired chemotherapy arm (P = 0.07). The relapse rate in the allo-HCT cohort was 30.58% compared to 21.68% in the pediatric-inspired chemotherapy arm (P = 0.16). The NRM in the allo-HCT cohort was 10.59 as compared to 6.45 in the pediatric-inspired chemotherapy arm (P = 0.3). For adolescent and adult patients with Ph-negative ALL, pediatric-inspired chemotherapy resulted in higher OS compared to allo-HCT.
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