Clinician Concepts of Cure in Adult Relapsed and Refractory Philadelphia-Negative B Cell Precursor Acute Lymphoblastic Leukemia: A Delphi Study

Adv Ther. 2019 Apr;36(4):870-879. doi: 10.1007/s12325-019-00910-z. Epub 2019 Mar 7.

Abstract

Introduction: Despite the poor prognosis for adults with relapsed or refractory (RR) Philadelphia chromosome (Ph)-negative B cell precursor acute lymphoblastic leukemia (ALL), long-term survival is possible and may even be considered as "cure".

Methods: This study used a Delphi panel approach to explore concepts of cure in RR Ph-negative B cell precursor ALL. Ten European experts in this disease area participated in a survey and face-to-face panel meeting.

Results: Findings showed that clinicians conceptualize "cure" as a combination of three broad treatment outcomes that vary depending on the treatment stage: complete remission early in treatment (1-3 months) indicates initial success; eradicating cancer cells (minimal residual disease negative status) consolidates the early clinical response; leukemia-free survival is required in the long term.

Conclusions: Although such terminology remains contested, clinicians would begin considering "cure" as early as 2 years provided the patient is off therapy, with most considering the term applicable by the third year.

Funding: Amgen Inc.

Keywords: B cell precursor acute lymphoblastic leukemia; Cure; Oncology; Outcomes; Refractory ALL; Relapsed ALL; Survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Consensus
  • Delphi Technique
  • Disease-Free Survival
  • Humans
  • Neoplasm, Residual / diagnosis
  • Philadelphia Chromosome
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma* / pathology
  • Prognosis
  • Proof of Concept Study
  • Recurrence
  • Remission Induction*
  • Treatment Outcome*

Associated data

  • figshare/10.6084/m9.figshare.7713515