Effects of intensive induction and consolidation chemotherapy with idarubicin and high dose cytarabine on minimal residual disease levels in newly diagnosed adult precursor-B acute lymphoblastic leukemia
AuthorBradstock, KF; Morley, A; Byth, K; Szer, J; Prosser, I; Cannell, P; Irving, I; Seymour, JF
Source TitleContemporary Clinical Trials Communications
AffiliationMedicine and Radiology
Document TypeJournal Article
CitationsBradstock, K. F., Morley, A., Byth, K., Szer, J., Prosser, I., Cannell, P., Irving, I. & Seymour, J. F. (2016). Effects of intensive induction and consolidation chemotherapy with idarubicin and high dose cytarabine on minimal residual disease levels in newly diagnosed adult precursor-B acute lymphoblastic leukemia. CONTEMPORARY CLINICAL TRIALS COMMUNICATIONS, 4, pp.9-13. https://doi.org/10.1016/j.conctc.2016.06.004.
Access StatusOpen Access
An intensive induction regimen, consisting of idarubicin and high dose cytarabine, was assessed in 19 adult patients, median age 44 years, with newly diagnosed precursor-B acute lymphoblastic leukemia (ALL). Patients achieving a complete response (CR) were given an attenuated consolidation course. The primary endpoints were induction death rate and incidence of serious non-hematological toxicity. Grades 3-4 diarrhoea occurred in 47% of patients during induction. Two patients (11%) died during induction therapy, and 2 were withdrawn due to resistant disease or prolonged marrow hypoplasia. Fifteen patients achieved CR (79%), but levels of minimal residual disease (MRD) after induction were comparable with those previously observed using a modified pediatric protocol. Overall survival at 5 years was 36.8% while leukemia-free survival was 44.1%. An intensive AML protocol used in adults with ALL resulted in substantial toxicity and provided similar levels of cytoreduction to conventional ALL protocols, without improving long-term outcomes.
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