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- Title
Treatment of Ph-Negative Acute Lymphoblastic Leukemia in Adolescents and Young Adults with an Affordable Outpatient Pediatric Regimen.
- Authors
Leôn, Andrés Gômez-De; Varela-Constantino, Ana L.; Colunga-Pedraza, Perla R.; Sanchez-Arteaga, Alexia; Garcia-Zarate, Valeria; Rodriguez-Zuniga, Anna Cecilia; Méndez-Ramirez, Nereida; Cantu-Rodriguez, Olga G.; Gutiérrez-Aguirre, César H.; Tarin-Arzaga, Luz; Gonzalez-Lopez, Elias E.; Jaime-Pérez, José Carlos; Gômez-Almaguer, David; Gómez-De León, Andrés; Sánchez-Arteaga, Alexia; García-Zárate, Valeria; Rodríguez-Zúñiga, Anna Cecilia; Méndez-Ramírez, Nereida; Cantú-Rodríguez, Olga G; Tarín-Arzaga, Luz
- Abstract
<bold>Background: </bold>B-cell acute lymphoblastic leukemia is frequent in Hispanic adolescents and young adults. Outcomes of implementation of pediatric-inspired regimens in low-and middle-income countries are not well known.<bold>Methods: </bold>In this study we treated 94 adolescents and young adults with a local BFM regimen designed to be affordable with the use of native L-asparaginase and mitoxantrone administered in an outpatient fashion, and the of BCR/ABL and measurable residual disease (MRD) determined by high sensitivity flow cytometry for risk stratification.<bold>Results: </bold>Induction mortality was 11%; 25% of patients had to abandon treatment or be transferred to another health system. Two-year overall (OS) and event free survival (EFS) were 61.5% and 49.8%, MRD-negative patients had a 24-month OS of 85.6% vs. 69.6% (p = .024) and EFS of 76% vs. 45.5% (p = .004). Patients older than 40 years and those who abandoned treatment had worse EFS. Overall drug costs in our regimen were 52% lower than those of CALGB10403.<bold>Conclusion: </bold> The treatment of AYAs with ALL with an outpatient focus was implemented successfully at a reduced cost. Genetic risk assessment, treatment abandonment and lack of access to novel therapies remain major barriers for improving outcomes.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2022, Vol 22, Issue 12, p883
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2022.07.014