Portal de investigación
Outcomes and prognostic factors of adults with refractory or relapsed T-cell acute lymphoblastic leukemia included in measurable residual disease-oriented trials
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Ribera, JM
- Morgades, M
- Genesca, E
- Chapchap, EC
- Gil, C
- Garcia-Cadenas, I
- Barba, P
- Gonzalez-Campos, J
- de Llano, MPQ
- Torrent, A
- Ribera, J
- Granada, I
- Bernal, T
- Diaz-Beya, M
- Amigo, ML
- Coll, R
- Tormo, M
- Vall-llovera, F
- Gomez-Centurion, I
- Sanchez-Sanchez, MJ
- Soria, B
- Cladera, A
- Artola, MT
- Garcia-Guinon, A
- Gimenez-Conca, A
- Amador, ML
- Martinez-Sanchez, P
- Algarra, JL
- Vidal, MJ
- Alonso, N
- Maluquer, C
- Llorente, L
- Garcia-Boyero, R
- Ciudad, J
- Feliu, E
- Orfao, A
- PETHEMA Grp
Grupos
Abstract
Despite high complete remission (CR) rates with frontline therapy, relapses are frequent in adults with T-cell acute lymphoblastic leukemia (T-ALL) with limited salvage options. We analyzed the outcomes and prognostic factors for CR to salvage therapy and overall survival (OS) of patients with R/R T-ALL included in two prospective measurable residual disease-oriented trials. Seventy-five patients (70 relapsed, 5 refractory) were identified. Relapses occurred in bone marrow, isolated or combined in 50 patients, and in the central nervous system (CNS; isolated or combined) in 20. Second CR was attained in 30/75 patients (40%). Treatment with FLAG-Ida and isolated CNS relapse were independently associated with a higher CR rate after first salvage therapy. The median OS was 6.2 (95% confidence interval [CI], 3.9-8.6) months, with a 4-year OS probability of 18% (95% CI, 9%-27%). No differences in survival were observed according to the treatment with hematopoietic stem cell transplantation in patients in CR after first salvage therapy. Multivariable analysis showed a >= 12-month interval between first CR and relapse, CR after first salvage therapy and isolated CNS relapse as favorable prognostic factors for OS with hazard ratios (HR) (95% CI) of 1.931 (1.109-3.362), 2.958 (1.640-5.334), and 2.976 (1.157-7.655), respectively. This study confirms the poor outcomes of adults with R/R T-ALL among whom FLAG-Ida was the best of the rescue therapies evaluated. Late relapse, CR after first rescue therapy and isolated CNS relapse showed prognostic impact on survival. More effective rescue therapies are needed in adults with R/R T-ALL.
Datos de la publicación
- ISSN/ISSNe:
- 0278-0232, 1099-1069
- Tipo:
- Article
- Páginas:
- 529-538
- DOI:
- 10.1002/hon.2910
- PubMed:
- 34405901
- Factor de Impacto:
- 0,971 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
HEMATOLOGICAL ONCOLOGY WILEY
Citas Recibidas en Web of Science: 9
Documentos
- No hay documentos
Filiaciones
Keywords
- acute lymphoblastic leukemia; refractory; relapsed; outcome; T-cell
Campos de Estudio
Cita
Ribera JM,Morgades M,Genesca E,Chapchap EC,MONTESINOS P,ACUNA E,Gil C,Garcia I,Barba P,Gonzalez J,de Llano MPQ,Torrent A,Ribera J,Granada I,Bernal T,Diaz M,Amigo ML,Coll R,Tormo M,Vall F,Gomez I,Sanchez MJ,Soria B,Cladera A,Artola MT,Garcia A,Gimenez A,Amador ML,Martinez P,Algarra JL,Vidal MJ,Alonso N,Maluquer C,Llorente L,Garcia R,Ciudad J,Feliu E,Orfao A,PETHEMA GRP. Outcomes and prognostic factors of adults with refractory or relapsed T-cell acute lymphoblastic leukemia included in measurable residual disease-oriented trials. Hematol. Oncol. 2021. 39. (4):p. 529-538. IF:4,850. (2).