Outcome of adolescents and young adults with acute lymphoblastic leukemia in a single center in Brazil

Thais Ferraz Aguiar; Thayana da Conceição Barbosa; Ana Luiza Tardem Maciel; Caroline Barbieri Blunck; João Sellos-Laclette; Andreia Cristina de Melo; Marcela B Mansur; Mariana Emerenciano

doi:10.1016/j.htct.2022.06.006

Outcome of adolescents and young adults with acute lymphoblastic leukemia in a single center in Brazil

Hematol Transfus Cell Ther. 2023 Jul;45 Suppl 2(Suppl 2):S108-S112. doi: 10.1016/j.htct.2022.06.006. Epub 2022 Aug 1.

Authors

Thais Ferraz Aguiar¹, Thayana da Conceição Barbosa², Ana Luiza Tardem Maciel², Caroline Barbieri Blunck², João Sellos-Laclette², Andreia Cristina de Melo², Marcela B Mansur³, Mariana Emerenciano⁴

Affiliations

¹ Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil; Instituto Estadual de Hematologia Arthur Siqueira Cavalcanti, Rio de Janeiro, RJ, Brazil.
² Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil.
³ Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil; Children's Hospital, John Radcliffe Hospital, Oxford, UK; Weatherall Institute of Molecular Medicine -WIMM, University of Oxford, Oxford, UK.
⁴ Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil. Electronic address: memerenciano@inca.gov.br.

Abstract

Introduction: Acute lymphoblastic leukemia (ALL) presents a poor prognosis in adults. The adoption of pediatric protocols has been changing this scenario, especially for adolescents and young adults (AYA).

Objective and method: We aimed to evaluate a consecutive series of patients treated at the State Institute of Hematology of Rio de Janeiro between 2012 and 2020, focusing on the AYA subgroup.

Result: The B-ALL was the most frequent subtype (81.6%) and AYA, the predominant age group (57.7%). The median overall survival (OS) was 9.4 months. High early mortality was observed and sepsis was the main cause of death. Better OS results were noted in AYA, in comparison to over 39y (13.3 × 6.2 months, respectively), the Berlin-Frankfurt-Münster (BFM) being the protocol of choice in this group.

Conclusion: The use of the pediatric protocol seems to improve the OS of AYA, however, high rates of deaths from infection were observed, demonstrating the need for advances in the Brazilian public system clinical support.

Keywords: Acute lymphoblastic leukemia; Adolescents and young adults; Latin America; Survival.