TY - JOUR
T1 - Outcome differences in patients with precursor B cell acute lymphocytic leukemia over time
T2 - A retrospective analysis
AU - Apel, Arie
AU - Kedmi, Meirav
AU - Levi, Etai
AU - Berkowicz, Miriam
AU - Davidovitz, Yaron
AU - Kneller, Abraham
AU - Ribakovsky, Elena
AU - Shimoni, Avichai
AU - Nagler, Arnon
AU - Avigdor, Abraham
PY - 2014
Y1 - 2014
N2 - Background: Acute lymphocytic leukemia (ALL) is a rare disease with a poor outcome in adults. Over the years different protocols have been developed with the aim of improving the outcome. The German study group protocols (GMALL), which are the most frequently used in our institutions, changed significantly between the periods 1989-93 and 1999-2003. Objectives: To investigate whether the change in protocols over the years resulted in an outcome difference at two hospitals in Israel. Methods: We thoroughly reviewed the records of 153 patients from Sheba Medical Center and Soroka Medical Center, of whom 106 comprised the study group. The patients were divided into two groups according to the treatment protocol used: 40 patients with the 1989/93 protocol and 66 with the 1999/2003 protocol. Outcome was analyzed for the two groups. Results: We found a significant difference in disease-free survival (DFS) between the two groups for B cell-ALL (B-ALL) patients who achieved complete remission after induction. There was no difference in overall survival. We did not find any difference in outcome for T cell-ALL patients or for CD20- positive patients. Conclusions: In our retrospective analysis, GMALL 99/2003 led to a better DFS for B-ALL patients who were in complete remission after induction. This is possibly related to the differences in medications between the protocols but may also be due to better supportive care. Despite the proven advantage of the newer protocols regarding overall survival, in our experience there was no other significant difference between the two regimens.
AB - Background: Acute lymphocytic leukemia (ALL) is a rare disease with a poor outcome in adults. Over the years different protocols have been developed with the aim of improving the outcome. The German study group protocols (GMALL), which are the most frequently used in our institutions, changed significantly between the periods 1989-93 and 1999-2003. Objectives: To investigate whether the change in protocols over the years resulted in an outcome difference at two hospitals in Israel. Methods: We thoroughly reviewed the records of 153 patients from Sheba Medical Center and Soroka Medical Center, of whom 106 comprised the study group. The patients were divided into two groups according to the treatment protocol used: 40 patients with the 1989/93 protocol and 66 with the 1999/2003 protocol. Outcome was analyzed for the two groups. Results: We found a significant difference in disease-free survival (DFS) between the two groups for B cell-ALL (B-ALL) patients who achieved complete remission after induction. There was no difference in overall survival. We did not find any difference in outcome for T cell-ALL patients or for CD20- positive patients. Conclusions: In our retrospective analysis, GMALL 99/2003 led to a better DFS for B-ALL patients who were in complete remission after induction. This is possibly related to the differences in medications between the protocols but may also be due to better supportive care. Despite the proven advantage of the newer protocols regarding overall survival, in our experience there was no other significant difference between the two regimens.
KW - Acute lymphoblastic lymphoma (ALL)
KW - German multi-center trial for adult ALL (GMALL) protocol
KW - Overall survival
KW - Progression-free survival
UR - http://www.scopus.com/inward/record.url?scp=84898400785&partnerID=8YFLogxK
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 24834758
AN - SCOPUS:84898400785
SN - 1565-1088
VL - 16
SP - 224
EP - 228
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 4
ER -
