A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: Results of CALGB 10403

Wendy Stock, Selina M. Luger, Anjali S. Advani, Jun Yin, Richard C. Harvey, Charles G. Mullighan, Cheryl L. Willman, Noreen Fulton, Kristina M. Laumann, Greg Malnassy, Elisabeth Paietta, Edy Parker, Susan Geyer, Krzysztof Mrózek, Clara D. Bloomfield, Ben Sanford, Guido Marcucci, Michaela Liedtke, David F. Claxton, Matthew C. FosterJeffrey A. Bogart, John C. Grecula, Frederick R. Appelbaum, Harry Erba, Mark R Litzow, Martin S. Tallman, Richard M. Stone, Richard A. Larson

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Retrospective studies have suggested that older adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL) have better survival rates when treated using a pediatric ALL regimen administered by pediatric treatment teams. To address the feasibility and efficacy of using a pediatric treatment regimen for AYA patients with newly diagnosed ALL administered by adult treatment teams, we performed a prospective study, CALGB 10403, with doses and schedule identical to those in the Children’s Oncology Group study AALL0232. From 2007 to 2012, 318 patients were enrolled; 295 were eligible and evaluable for response. Median age was 24 years (range, 17-39 years). Use of the pediatric regimen was safe; overall treatment-related mortality was 3%, and there were only 2 postremission deaths. Median event-free survival (EFS) was 78.1 months (95% confidence interval [CI], 41.8 to not reached), more than double the historical control of 30 months (95% CI, 22-38 months); 3-year EFS was 59% (95% CI, 54%-65%). Median overall survival (OS) was not reached. Estimated 3-year OS was 73% (95% CI, 68%-78%). Pretreatment risk factors associated with worse treatment outcomes included obesity and presence of the Philadelphia-like gene expression signature. Use of a pediatric regimen for AYAs with ALL up to age 40 years was feasible and effective, resulting in improved survival rates compared with historical controls. CALGB 10403 can be considered a new treatment standard upon which to build for improving survival for AYAs with ALL.

Original languageEnglish (US)
Pages (from-to)1548-1559
Number of pages12
JournalBlood
Volume133
Issue number14
DOIs
StatePublished - Apr 4 2019

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Pediatrics
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Young Adult
Confidence Intervals
Disease-Free Survival
Survival
Survival Rate
Therapeutics
Oncology
Transcriptome
Gene expression
Appointments and Schedules
Retrospective Studies
Obesity
Prospective Studies
Mortality

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Stock, W., Luger, S. M., Advani, A. S., Yin, J., Harvey, R. C., Mullighan, C. G., ... Larson, R. A. (2019). A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: Results of CALGB 10403. Blood, 133(14), 1548-1559. https://doi.org/10.1182/blood-2018-10-881961

A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia : Results of CALGB 10403. / Stock, Wendy; Luger, Selina M.; Advani, Anjali S.; Yin, Jun; Harvey, Richard C.; Mullighan, Charles G.; Willman, Cheryl L.; Fulton, Noreen; Laumann, Kristina M.; Malnassy, Greg; Paietta, Elisabeth; Parker, Edy; Geyer, Susan; Mrózek, Krzysztof; Bloomfield, Clara D.; Sanford, Ben; Marcucci, Guido; Liedtke, Michaela; Claxton, David F.; Foster, Matthew C.; Bogart, Jeffrey A.; Grecula, John C.; Appelbaum, Frederick R.; Erba, Harry; Litzow, Mark R; Tallman, Martin S.; Stone, Richard M.; Larson, Richard A.

In: Blood, Vol. 133, No. 14, 04.04.2019, p. 1548-1559.

Research output: Contribution to journalArticle

Stock, W, Luger, SM, Advani, AS, Yin, J, Harvey, RC, Mullighan, CG, Willman, CL, Fulton, N, Laumann, KM, Malnassy, G, Paietta, E, Parker, E, Geyer, S, Mrózek, K, Bloomfield, CD, Sanford, B, Marcucci, G, Liedtke, M, Claxton, DF, Foster, MC, Bogart, JA, Grecula, JC, Appelbaum, FR, Erba, H, Litzow, MR, Tallman, MS, Stone, RM & Larson, RA 2019, 'A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: Results of CALGB 10403', Blood, vol. 133, no. 14, pp. 1548-1559. https://doi.org/10.1182/blood-2018-10-881961
Stock, Wendy ; Luger, Selina M. ; Advani, Anjali S. ; Yin, Jun ; Harvey, Richard C. ; Mullighan, Charles G. ; Willman, Cheryl L. ; Fulton, Noreen ; Laumann, Kristina M. ; Malnassy, Greg ; Paietta, Elisabeth ; Parker, Edy ; Geyer, Susan ; Mrózek, Krzysztof ; Bloomfield, Clara D. ; Sanford, Ben ; Marcucci, Guido ; Liedtke, Michaela ; Claxton, David F. ; Foster, Matthew C. ; Bogart, Jeffrey A. ; Grecula, John C. ; Appelbaum, Frederick R. ; Erba, Harry ; Litzow, Mark R ; Tallman, Martin S. ; Stone, Richard M. ; Larson, Richard A. / A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia : Results of CALGB 10403. In: Blood. 2019 ; Vol. 133, No. 14. pp. 1548-1559.
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abstract = "Retrospective studies have suggested that older adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL) have better survival rates when treated using a pediatric ALL regimen administered by pediatric treatment teams. To address the feasibility and efficacy of using a pediatric treatment regimen for AYA patients with newly diagnosed ALL administered by adult treatment teams, we performed a prospective study, CALGB 10403, with doses and schedule identical to those in the Children’s Oncology Group study AALL0232. From 2007 to 2012, 318 patients were enrolled; 295 were eligible and evaluable for response. Median age was 24 years (range, 17-39 years). Use of the pediatric regimen was safe; overall treatment-related mortality was 3{\%}, and there were only 2 postremission deaths. Median event-free survival (EFS) was 78.1 months (95{\%} confidence interval [CI], 41.8 to not reached), more than double the historical control of 30 months (95{\%} CI, 22-38 months); 3-year EFS was 59{\%} (95{\%} CI, 54{\%}-65{\%}). Median overall survival (OS) was not reached. Estimated 3-year OS was 73{\%} (95{\%} CI, 68{\%}-78{\%}). Pretreatment risk factors associated with worse treatment outcomes included obesity and presence of the Philadelphia-like gene expression signature. Use of a pediatric regimen for AYAs with ALL up to age 40 years was feasible and effective, resulting in improved survival rates compared with historical controls. CALGB 10403 can be considered a new treatment standard upon which to build for improving survival for AYAs with ALL.",
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AU - Stock, Wendy

AU - Luger, Selina M.

AU - Advani, Anjali S.

AU - Yin, Jun

AU - Harvey, Richard C.

AU - Mullighan, Charles G.

AU - Willman, Cheryl L.

AU - Fulton, Noreen

AU - Laumann, Kristina M.

AU - Malnassy, Greg

AU - Paietta, Elisabeth

AU - Parker, Edy

AU - Geyer, Susan

AU - Mrózek, Krzysztof

AU - Bloomfield, Clara D.

AU - Sanford, Ben

AU - Marcucci, Guido

AU - Liedtke, Michaela

AU - Claxton, David F.

AU - Foster, Matthew C.

AU - Bogart, Jeffrey A.

AU - Grecula, John C.

AU - Appelbaum, Frederick R.

AU - Erba, Harry

AU - Litzow, Mark R

AU - Tallman, Martin S.

AU - Stone, Richard M.

AU - Larson, Richard A.

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N2 - Retrospective studies have suggested that older adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL) have better survival rates when treated using a pediatric ALL regimen administered by pediatric treatment teams. To address the feasibility and efficacy of using a pediatric treatment regimen for AYA patients with newly diagnosed ALL administered by adult treatment teams, we performed a prospective study, CALGB 10403, with doses and schedule identical to those in the Children’s Oncology Group study AALL0232. From 2007 to 2012, 318 patients were enrolled; 295 were eligible and evaluable for response. Median age was 24 years (range, 17-39 years). Use of the pediatric regimen was safe; overall treatment-related mortality was 3%, and there were only 2 postremission deaths. Median event-free survival (EFS) was 78.1 months (95% confidence interval [CI], 41.8 to not reached), more than double the historical control of 30 months (95% CI, 22-38 months); 3-year EFS was 59% (95% CI, 54%-65%). Median overall survival (OS) was not reached. Estimated 3-year OS was 73% (95% CI, 68%-78%). Pretreatment risk factors associated with worse treatment outcomes included obesity and presence of the Philadelphia-like gene expression signature. Use of a pediatric regimen for AYAs with ALL up to age 40 years was feasible and effective, resulting in improved survival rates compared with historical controls. CALGB 10403 can be considered a new treatment standard upon which to build for improving survival for AYAs with ALL.

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