Efficacy and toxicity of a paediatric protocol in teenagers and young adults with Philadelphia chromosome negative acute lymphoblastic leukaemia: results from UKALL 2003

Summary Despite the substantial outcome improvements achieved in paediatric acute lymphoblastic leukaemia (ALL), survival in teenage and young adult (TYA) patients has remained inferior. We report the treatment outcomes and toxicity profiles observed in TYA patients treated on the UK paediatric ALL...

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Bibliographic Details
Published in:British journal of haematology 2016-02, Vol.172 (3), p.439-451
Main Authors: Hough, Rachael, Rowntree, Clare, Goulden, Nick, Mitchell, Chris, Moorman, Anthony, Wade, Rachel, Vora, Ajay
Format: Article
Language:English
Subjects:
acute lymphoblastic leukaemia
Adolescent
Age Factors
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Asparaginase - administration & dosage
Asparaginase - adverse effects
chemotherapy
Child
Child, Preschool
Daunorubicin - administration & dosage
Daunorubicin - adverse effects
Dexamethasone - administration & dosage
Dexamethasone - adverse effects
efficacy
Female
Humans
Male
Mercaptopurine - administration & dosage
Mercaptopurine - adverse effects
Methotrexate - administration & dosage
Methotrexate - adverse effects
Neoplasm, Residual
Philadelphia Chromosome
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology
Risk Assessment - methods
Survival Analysis
teenage and young adult
toxicity
Treatment Outcome
Vincristine - administration & dosage
Vincristine - adverse effects
Young Adult
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Summary:Summary Despite the substantial outcome improvements achieved in paediatric acute lymphoblastic leukaemia (ALL), survival in teenage and young adult (TYA) patients has remained inferior. We report the treatment outcomes and toxicity profiles observed in TYA patients treated on the UK paediatric ALL trial, UKALL2003. UKALL2003 was a multi‐centre, prospective, randomized phase III trial, investigating treatment intensification or de‐escalation according to minimal residual disease (MRD) kinetics at the end of induction. Of 3126 patients recruited to UKALL2003, 229 (7·3%) were aged 16–24 years. These patients were significantly more likely to have high risk MRD compared to 10–15 year olds (47·9% vs. 36·6%, P = 0·004). Nonetheless, 5‐year event‐free survival for the TYA cohort (aged 16–24 years) was 72·3% [95% confidence interval (CI): 66·2–78·4] overall and 92·6% (95% CI: 85·5–99·7) for MRD low risk patients. The risk of serious adverse events was higher in patients aged ≥10 years compared to those aged 9 or younger (P 
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.13847