A RETROSPECTIVE EVALUATION OF ADOLESCENT AND YOUNG ADULT ACUTE LYMPHOBLASTIC LEUKEMIA PATIENTS TREATED WITH COG0232 REGIMEN.

Main Article Content

Shivani Shokhanda
Vipin Kumar
Dr Ashwani Kumar
Om Joshi
Neetu jangra

Keywords

COG regimen, adolescent and young adults, acute lymphoblastic leukemia, event-free survival, overall survival

Abstract

Purpose: Considering the young age and good tolerability to chemotherapies, adolescents and young adults (AYA) patients with acute lymphoblastic leukemia (ALL) are nowadays treated with more intensive pediatric protocols and consequently demonstrated improved outcomes in several studies. The purpose of this study was to evaluate the efficacy of  COG0232 regimen on AYA ALL patients.


Methods: Medical records of newly diagnosed ALL patients registered between 2012- 2016 were screened. We analyzed data of 115 patients retrospectively for their post- induction remission, mortality and survival rates.


Results: Out of 115 patients, complete remission (CR) was achieved in 90 patients post induction chemotherapy. Additionally, after receiving salvage induction 02 patients achieved CR. Therefore, we observed an overall CR rate of 80%. MRD was found positive in 34.2% and negative in 65.8% patients at the end of induction. Majority of the 16 MRD positives (77%) were observed in B-ALL group. The event-free survival (EFS) and overall survival (OS) reported were 51.3% and 54% respectively, with more than 4 years of follow-up. EFS and OS were found significantly associated with post-induction remission (p-value = <0.0001, <0.0001 respectively) and post-induction MRD (p-value = <0.0075, <0.0275 respectively).


Conclusion: In conclusion, using a pediatric regimen for AYAs with ALL up to the age of 40 years is a feasible and beneficial treatment option, resulting in better survival rates.

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