Elderly acute lymphoblastic leukemia: a Mayo Clinic study of 124 patients

Kevin C. Miller, Aref Al-Kali, Mithun V. Shah, William J. Hogan, Michelle A. Elliott, Kebede H. Begna, Naseema Gangat, Mrinal M. Patnaik, David S. Viswanatha, Rong He, Patricia T. Greipp, Lisa Z. Sproat, James M. Foran, Mark R. Litzow, Hassan B. Alkhateeb

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Poor outcomes in elderly acute lymphoblastic leukemia (ALL) are well recognized, but the contributors are ill-defined. We characterized 124 patients ≥60 years old at our institution. The majority (n = 102, 82%) were treated with intensive chemotherapy. Of these, 8/102 (8%) died within the first 100 days; 92/102 (90%) achieved complete remission (CR/CRi). Only 31/124 (25%) patients underwent allogeneic hematopoietic stem cell transplantation. The median overall survival (OS) for the entire cohort was 19.8 months. In a multivariate analysis, ECOG performance status ≥2, high white blood cell count, and high lactate dehydrogenase (at time of diagnosis) negatively influenced OS (p<.01). In a subgroup analysis of the intensive treatment group, BCR-ABL1+ patients had markedly better OS (hazard ratio 0.3, 95% CI 0.1–0.7; p<.01). In summary, despite few early deaths and a high CR/CRi rate, elderly ALL continues to have a poor prognosis, underscoring the need for more effective therapies.

Original languageEnglish (US)
Pages (from-to)990-999
Number of pages10
JournalLeukemia and Lymphoma
Volume60
Issue number4
DOIs
StatePublished - Mar 21 2019

Keywords

  • BCR-ABL1; transplant
  • Elderly
  • acute lymphoblastic leukemia (ALL)
  • survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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