Treatment of adult patients with acute lymphoblastic leukemia in the Czech Republic in the period 2007-2020
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61989592%3A15110%2F23%3A73621321" target="_blank" >RIV/61989592:15110/23:73621321 - isvavai.cz</a>
Result on the web
<a href="https://www.prolekare.cz/en/journals/clinical-oncology/2023-4-10/treatment-of-adult-patients-with-acute-lymphoblastic-leukemia-in-the-czech-republic-in-the-period-2007-2020-135465?hl=cs" target="_blank" >https://www.prolekare.cz/en/journals/clinical-oncology/2023-4-10/treatment-of-adult-patients-with-acute-lymphoblastic-leukemia-in-the-czech-republic-in-the-period-2007-2020-135465?hl=cs</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.48095/ccko2023382" target="_blank" >10.48095/ccko2023382</a>
Alternative languages
Result language
angličtina
Original language name
Treatment of adult patients with acute lymphoblastic leukemia in the Czech Republic in the period 2007-2020
Original language description
Background: Pediatric-inspired protocols with prospective monitoring of minimal residual disease (MRD) are considered the standard of intensive treatment for adults with acute lymphoblastic leukemia (ALL). They have been used in the Czech Republic since 2007. Patients and methods: Two hundred and ninety-seven patients aged 18–65 years were treated at five hematology centers between 2007–2020 according to the GMALL 07/ 2003 protocol. This is a retrospective analysis of their treatment outcomes. Results: In the Ph-negative cohort, 189 (93.1%) patients achieved complete remission, 5 (2.4%) patients were refractory, and early mortality was 3.0%. Seventy (34.5%) patients experienced relapse in a median of 10.6 months. Overall survival (OS) at 3 and 5 years was 63.5% and 55.9%, disease-free survival (DFS) at 3 and 5 years was 54.5% and 49.7%, respectively. Young adults under 35 years of age (P = 0.015), patients without initial CNS infiltration (P = 0.016), with MRD negativity before consolidation treatment (P < 0.001), transplanted in the 1st complete remission (P < 0.001), and subjects treated after 2012 (P = 0.05) had significantly better overall survival. In a multivariate analysis, MRD at week 11 was the only independent factor affecting OS (HR 3.06; P = 0.006). For DFS, baseline CNS infiltration (HR 2.08; P = 0.038) and MRD at week 11 (HR 2.15; P = 0.020) were significant. In the Ph-positive cohort, 84 (89.4%) patients achieved complete remission, 1 (1.0%) patient was refractory, early mortality was 4.3%. Twenty-six (27.7%) patients relapsed in a median of 8.6 months. Survival at 3 and 5 years was 57.2% and 52.4% for OS and 50.2% and 44.9% for DFS, respectively. Transplanted patients and patients dia gnosed after 2012 had statistically better overall survival (P < 0.001). Conclusion: The introduction of pediatric-inspired protocols with treatment intensification according to MRD levels resulted in a significant improvement in the survival outcomes of adult patients with ALL.
Czech name
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Czech description
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Classification
Type
J<sub>SC</sub> - Article in a specialist periodical, which is included in the SCOPUS database
CEP classification
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OECD FORD branch
30205 - Hematology
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Klinicka Onkologie
ISSN
0862-495X
e-ISSN
1802-5307
Volume of the periodical
36
Issue of the periodical within the volume
5
Country of publishing house
CZ - CZECH REPUBLIC
Number of pages
14
Pages from-to
382-395
UT code for WoS article
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EID of the result in the Scopus database
2-s2.0-85175269698