Comparison of CALGB 10403 (Alliance) and COG AALL0232 toxicity results in young adults with acute lymphoblastic leukemia

Anjali S. Advani, Eric Larsen, Kristina Laumann, Selina M. Luger, Michaela Liedtke, Meenakshi Devidas, Zhiguo Chen, Jun Yin, Matthew C. Foster, David Claxton, Kristin Coffan, Martin S. Tallman, Frederick R. Appelbaum, Harry Erba, Richard M. Stone, Stephen P. Hunger, Jennifer L. McNeer, Mignon L. Loh, Elizabeth Raetz, Naomi WinickWilliam Carroll, Richard A. Larson, Wendy Stock

Research output: Contribution to journalArticlepeer-review

Abstract

Adolescents and young adults (AYAs) with acute lymphoblastic leukemia have improved outcomes when treated with pediatric-inspired regimens. CALGB 10403 was the largest prospective study to evaluate the feasibility of using a pediatric regimen in AYAs with acute lymphoblastic leukemia up to 40 years of age. This article presents the toxicity events observed in the CALGB 10403 study and compares these toxicities vs those observed among AYAs treated on the same arm of the companion Children's Oncology Group (COG) AALL0232 study. Toxicities in CALGB 10403 were similar to those observed in COG AALL0232. Some grade 3 to 4 adverse events were more often reported in CALGB 10403 compared with COG AALL0232 (hyperglycemia, hyperbilirubinemia, transaminase elevation, and febrile neutropenia). Adverse events correlated with body mass index $30 kg/m2 and some with increasing age. The mortality rate in CALGB 10403 was low (4%) and similar to that in the COG AALL0232 trial. A caveat to this analysis is that only 39% of CALGB 10403 patients completed all planned protocol treatment. In COG AALL0232, although 74% of patients aged ,18 years completed treatment, only 57% of patients aged $18 years completed treatment. This scenario suggests that issues associated with age and treating physician may be a factor. Due to its improved survival rates compared with historical controls, the CALGB 10403 regimen is now a standard of care. The hope is that the rate of protocol completion will increase as more familiarity is gained with this regimen. These trials were registered at www.clinicaltrials.gov as #NCT00558519 (CALGB 10403) and #NCT00075725 (COG AALL0232).

Original languageEnglish (US)
Pages (from-to)504-512
Number of pages9
JournalBlood Advances
Volume5
Issue number2
DOIs
StatePublished - Jan 26 2021

ASJC Scopus subject areas

  • Hematology

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