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

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

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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)
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - Jan 1 2018

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Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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