Improved survival in adolescents and young adults (AYA) patients aged 14-55 years with acute lymphoblastic leukemia using pediatric-inspired protocol - a retrospective analysis of a real-world experience in 79 of patients treated at a national tertiary care referral center

Amr Hanbali; Ahmed Kotb; Riad El Fakih; Feras Alfraih; Syed Osman Ahmed; Marwan Shaheen; Saud Alhayli; Ali Alahmari; Ahmad Alotaibi; Alfadel Alshaibani; Mahmoud Abu Riash; Farah Deeba; Maryam Asif; Walid Rasheed; Hazzaa Alzahrani; Fahad Alsharif; Naeem Chaudhri; Fahad Almohareb; Mahmoud Aljurf

doi:10.1016/j.lrr.2021.100270

Improved survival in adolescents and young adults (AYA) patients aged 14-55 years with acute lymphoblastic leukemia using pediatric-inspired protocol - a retrospective analysis of a real-world experience in 79 of patients treated at a national tertiary care referral center

Leuk Res Rep. 2021 Sep 24:16:100270. doi: 10.1016/j.lrr.2021.100270. eCollection 2021.

Authors

Amr Hanbali¹, Ahmed Kotb², Riad El Fakih¹, Feras Alfraih¹, Syed Osman Ahmed¹, Marwan Shaheen¹, Saud Alhayli¹, Ali Alahmari¹, Ahmad Alotaibi¹, Alfadel Alshaibani¹, Mahmoud Abu Riash¹, Farah Deeba³, Maryam Asif³, Walid Rasheed¹, Hazzaa Alzahrani¹, Fahad Alsharif¹, Naeem Chaudhri¹, Fahad Almohareb¹, Mahmoud Aljurf¹

Affiliations

¹ King Faisal Specialist Hospital, Riyadh, Saudi Arabia.
² Department of Medicine, Hematology unit, Zagazig University, Egypt.
³ Alfaisal University, Saudi Arabia.

Abstract

Background: Treating adolescents and young adults (AYA) patients with acute lymphoblastic leukemia (ALL) using pediatric-inspired protocols have shown improvement in outcomes. Most data available in the literature of such protocols is derived from well-controlled clinical trials. This report aims to provide a real-world experience from using a pediatric-inspired protocol in ALL-AYA population in larger number of patients treated at a national tertiary care referral center.

Methods: Newly diagnosed Philadelphia negative ALL-AYA patients ages between 14 and 55 years of age were treated on an institutional protocol (AYA-15 protocol) adopted from a modified version of Children's Cancer Group (CCG) 1900 protocol. At the time of this publication, a total of 79 patients were treated using the AYA-15 protocol between 2015 and 2020). Event-free survival (FFS), disease-free survival (DFS), and overall survival (OS) were analyzed using cumulative incidence and Kaplan-Meier methods.

Results: The median age at diagnosis was 18 years (14-51 years) with 63% male patients. Complete remission (CR) at day 28 of induction was achieved in 88.6% of which 73.4% were minimal residual disease (MRD) negative. At a median follow up of 5 years, EFS, DFS and OS were 57.5%, 69.2% and 75.8% respectively. Toxicities were within the expected range with infections and transaminitis being the most common adverse events.

Conclusion: Our single-center experience real-world data in treating AYA-ALL patients with pediatric-inspired protocol demonstrates encouraging results of high survival rate and excellent tolerability for patients aged 18-55 years.

Keywords: Acute lymphoblastic leukemia; Adolescents and young adults; Pediatric-inspired protocol.