Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/466
Title: Outcome after relapse of acute lymphoblastic leukemia in adult patients included in four consecutive risk-adapted trials by the PETHEMA Study Group
Authors: Oriol, Albert
Vives, Susana
Hernández Rivas, Jesús M.
Tormo, Mar
Heras, Inmaculada
Rivas, Concepción
Bethencourt, Concepción
Moscardó, Federico
Bueno, Javier
Grande, Carlos
del Potro, Eloy
Guardia, Ramon
Brunet, Salut
Bergua, Juan
Bernal, Teresa
Moreno, M.José
Calvo, Carlota
Bastida, Pilar
Feliu, Evarist
Ribera, Josep M.
metadata.dc.contributor.authoraffiliation: [Oriol,A; Vives,S; Feliu,E; Ribera,JM] Servei d’Hematologia Clínica,Institut Català d’Oncologia,Hospital Germans Trias i Pujol,Badalona,Spain. [Hernández Rivas,JM] Hospital Clínico Universitario,Salamanca. [Tormo,M] Hospital Clínico Universitario,Valencia. [Heras,I] Hospital Morales Meseguer,Murcia. [Rivas,C] Hospital General,Alicante. [Bethencourt,C] Hospital Universitario Carlos Haya,Málaga. [Moscardó,F] Hospital La Fe,Valencia. [Bueno,J] Hospital de la Vall d’Hebron,Barcelona. [Grande,C] Hospital Doce de Octubre,Madrid. [del Potro,E] Hospital Clínico San Carlos,Madrid. [Guardia,R] Hospital Josep Trueta,Girona. [Brunet,S] Hospital de Sant Pau,Barcelona. [Bergua,J] Hospital San Pedro de Alcántara,Cáceres. [Bernal,T] Hospital Central de Asturias, Oviedo. [Moreno,MJ] Hospital Virgen de la Victoria,Málaga. [Calvo,C] Hospital Miguel Servet,Zaragoza. [Bastida,P] Hospital Materno-Infantil de la Vall d’Hebron, Barcelona, Spain.
metadata.dc.contributor.group: Programa Español de Tratamiento en Hematologia (PETHEMA) Group
Keywords: acute lymphoblastic leukemia;relapse;rescue treatment;prognostic factors;Leucemia-Linfoma Linfoblástico de Células Precursoras;Recurrencia;Resultado del Tratamiento;Pronóstico
metadata.dc.subject.mesh: Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Evaluation Studies as Topic::Clinical Trials as Topic
Medical Subject Headings::Diseases::Neoplasms::Neoplastic Processes::Neoplasm Recurrence, Local
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Histologic Type::Leukemia::Leukemia, Lymphoid::Precursor Cell Lymphoblastic Leukemia-Lymphoma
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Transplantation::Cell Transplantation::Stem Cell Transplantation
Medical Subject Headings::Named Groups::Persons::Age Groups::Adolescent
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Remission Induction
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Survival Rate
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Young Adult
Issue Date: Apr-2010
Publisher: Ferrata Storti Foundation
Citation: Oriol A, Vives S, Hernandez-Rivas JM, Tormo M, Heras I, Rivas C, et al. Outcome after relapse of acute lymphoblastic leukemia in adult patients included in four consecutive risk-adapted trials by the PETHEMA Study Group. Haematologica-the Hematology Journal. 2010;95(4):589-96
Abstract: BACKGROUND About one half of adults with acute lymphoblastic leukemia are not cured of the disease and ultimately die. The objective of this study was to explore the factors influencing the outcome of adult patients with relapsed acute lymphoblastic leukemia. DESIGN AND METHODS. We analyzed the characteristics, the outcome and the prognostic factors for survival after first relapse in a series of 263 adult patients with acute lymphoblastic leukemia (excluding those with mature B-cell acute lymphoblastic leukemia) prospectively enrolled in four consecutive risk-adapted PETHEMA trials. RESULTS. The median overall survival after relapse was 4.5 months (95% CI, 4-5 months) with a 5-year overall survival of 10% (95% CI, 8%-12%); 45% of patients receiving intensive second-line treatment achieved a second complete remission and 22% (95% CI, 14%-30%) of them remained disease free at 5 years. Factors predicting a good outcome after rescue therapy were age less than 30 years (2-year overall survival of 21% versus 10% for those over 30 years old; P<0.022) and a first remission lasting more than 2 years (2-year overall survival of 36% versus 17% among those with a shorter first remission; P<0.001). Patients under 30 years old whose first complete remission lasted longer than 2 years had a 5-year overall survival of 38% (95% CI, 23%-53%) and a 5-year disease-free survival of 53% (95% CI, 34%-72%). CONCLUSIONS The prognosis of adult patients with acute lymphoblastic leukemia who relapse is poor. Those aged less than 30 years with a first complete remission lasting longer than 2 years have reasonable possibilities of becoming long-term survivors while patients over this age or those who relapse early cannot be successfully rescued using the therapies currently available.
Description: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't;
URI: http://hdl.handle.net/10668/466
metadata.dc.relation.publisherversion: http://www.haematologica.org/content/95/4/589.abstract
metadata.dc.identifier.doi: 10.3324/haematol.2009.014274
ISSN: 0390-6078 (Print)
1592-8721 (Online)
Appears in Collections:01- Artículos - Hospital Regional de Málaga

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