TY - JOUR
T1 - Elderly acute lymphoblastic leukemia
T2 - a Mayo Clinic study of 124 patients
AU - Miller, Kevin C.
AU - Al-Kali, Aref
AU - Shah, Mithun V.
AU - Hogan, William J.
AU - Elliott, Michelle A.
AU - Begna, Kebede H.
AU - Gangat, Naseema
AU - Patnaik, Mrinal M.
AU - Viswanatha, David S.
AU - He, Rong
AU - Greipp, Patricia T.
AU - Sproat, Lisa Z.
AU - Foran, James M.
AU - Litzow, Mark R.
AU - Alkhateeb, Hassan B.
N1 - Publisher Copyright:
© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019/3/21
Y1 - 2019/3/21
N2 - 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.
AB - 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.
KW - BCR-ABL1; transplant
KW - Elderly
KW - acute lymphoblastic leukemia (ALL)
KW - survival
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U2 - 10.1080/10428194.2018.1509318
DO - 10.1080/10428194.2018.1509318
M3 - Article
C2 - 30277111
AN - SCOPUS:85054399164
SN - 1042-8194
VL - 60
SP - 990
EP - 999
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 4
ER -