Abstract
Objective: Acute lymphoblastic leukemia (ALL) is one of the most common malignant diseases in children. This study aimed to determine the clinical and prognostic characteristics of adolescent patients with ALL aged 15–18 years who were followed up in our center.
Materials and Methods: The clinical and laboratory characteristics, treatment responses, and survival and relapse rates of adolescent patients with ALL were retrospectively analyzed
Results: The majority of patients were male. The median age of patients was 16 (range 15–17.9) years. About 36% and 74% of patients were diagnosed with T- and B-cell ALLs, respectively. Then, 32% of patients were stratified in the high-risk group. BCR/ABL t (9;22) positivity was detected in one patient. Recurrence was observed in 6 of 31 patients after completing the treatment. The estimated survival rate in the high-risk group at 32 months was 58%.
Conclusion: Ihe prognosis and outcomes of ALL in adolescent and young adult patients are poor compared to younger age groups. Future clinical trials and advance in chemotherapeutic protocols in this age group will help increase the treatment success rates
Keywords
References
- Curran E, Stock W. How I treat acute lymphoblastic leukemia in older adolescents and young adults. Blood. 2015; 125(24): 37023710. doi: 10.1182/blood-2014-11-551481 google scholar
- Inaba H, Mullighan CG. Pediatric acute lymphoblastic leukemia. Haematologica. 2020;105(11): 2524-2539. doi: 10.3324/ haematol.2020.247031 google scholar
- National Comprehensive Cancer Network. Adolescent and Young Adult Oncology Guidelines version 2.2014. 2014;12(1) : 21-32. doi:10.6004/jnccn.2014.0004 google scholar
- ALL IC-BFM 2009 protocol. Available on: www.bialaczka.org/ wp-content/uploads/2016/10/ALLIC_BFM_2009.pdf (Accessed date: 19 May 2020). google scholar
- Rajendra A, Jain H, Bonda VNA, Nayak L, Tembhare P, Shetty D, et al. Outcomes and prognostic factors in adolescents and young adults with ALL treated with a modified BFM-90 protocol. Blood Adv. 2021;5(5):1178-1193.doi: 10.1182/bloodadvances.2020003526 google scholar
- Nakata K, Okawa S, Fuji S, Sato A, Morishima T, Tada Y, et al. Trends in survival of leukemia among children, adolescents, and young adults: A population-based study in Osaka, Japan, the Osaka Cancer Association for Children, Adolescents, Young Adults. Cancer Sci. 2021; 112(3): 1150-1160. doi: 10.1111/cas.14808 google scholar
- Ravandi F. Current management of Philadelphia chromosome positive ALL and the role of stem cell transplantation. Hematology Am Soc Hematol Educ Program. 2017;2017(1):22-27. doi: 10.1182/ asheducation-2017.1.2 google scholar
- Boissel N, Sender LS. Best Practices in Adolescent and Young Adult Patients with Acute Lymphoblastic Leukemia: A Focus on Asparaginase. Journal of Adolescent and Young Adult Oncology. 2015;4(3):118-128. doi: 10.1089/jayao.2015.0014 google scholar
- Rytting ME, Jabbour EJ, O’Brien SM, Kantarjian HM, Acute Lymphoblastic Leukemia in Adolescents and Young Adults. Cancer. 2017;123(13):2398-2403. doi:10.1002/cncr.30624 google scholar
- Ganesan P, Jain H, Bagal B, Subramanian PG, George B, Korula A, et al. Outcomes in adolescent and young adult acute lymphoblastic leukaemia: a report from the Indian Acute Leukaemia Research Database (INwARD) of the Hematology Cancer Consortium (HCC). Br J Haematol. 2021; 193(1): doi:10.1111/bjh.17268.3 google scholar
- Lofstad GE, Reinfjell T, Hestad K, Diseth TH. Cognitive Outcome in Children and Adolescents Treated for Acute Lymphoblastic Leukaemia with Chemotherapy Only. Acta Pediatrica. 2008;98(1):180-186. doi: 10.1111/j.1651-2227.2008.01055.x google scholar
- Green DM, Kawashima T, Stovall M, Leisenring W, Sklar CA, Mertenset AC, et al. Fertility of Male Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. J Clin Oncol. 2010;28(2): 332-339. doi: 10.1200/JCO.2009.24.9037 google scholar
- Shliakhtsitsava K, Romero SAD, Dewald SR, Su HI. Pregnancy and child health outcomes in pediatric and young adult leukemia and lymphoma survivors: a systematic review. Leuk Lymphoma. 2018; 59(2): 381-397. doi:10.1080/10428194.2017.1352097 google scholar
- Green DM, Sklar CA, Boice JD Jr, Mulvihill JJ, Whitton JA, Stovall M, et al. Ovarian failure and reproductive outcomes after childhood cancer treatment: results from the Childhood Cancer Survivor Study. J Clin Oncol. 2009;27(14):2374-2381. doi: 10.1200/ JCO.2008.21.1839 google scholar
- Boissel N, Baruchel A, Acute lymphoblastic leukemia in adolescent and young adults: treat as adults or as children? Blood. 2018;132(4):351-361. doi: 10.1182/blood-2018-02-778530 google scholar
Abstract
Amaç: Akut lenfoblastik lösemi (ALL) çocukluk çağında en sık rastlanan habis hastalıklardan biridir. Çalışmamızda merkezimizde ALL tanısı ile takip ve tedavi edilen, 15-18 yaş arası adölesan hastaların klinik ve prognostik özelliklerini belirlemeyi amaçladık.
Gereç ve Yöntem: ALL’li adolesan hastaların klinik ve laboratuvar özellikleri, tedavi yanıtları, sağkalım ve nüks oranları retrospektif olarak analiz edildi.
Bulgular: Hastaların çoğunluğunu erkekler oluşturmaktaydı.Median yaş değeri 16 (15-17,9) yıl idi. Hastaların %32’si yüksek risk grubundaydı ve %26’sı T hücreli ALL %74’ü B hücreli ALL immunfenotipi göstermekteydi. BCRL/ABL t (9;22) pozitifliği bir hastada saptandı. Altı hastamızda tedavi bitimi sonrası nüks görüldü. Yüksek risk grubunda otuz ikinci ayda tahmini sağ kalım oranı %58 idi.
Sonuç: Ergen ve genç yetişkin hastaların prognozu ve sonuçları diğer küçük yaş gruplarından farklı olarak daha kötüdür. Çocukluk çağında kullanılan protokollerin, bu yaş grubuna özel klinik araştırmalarla geliştirilmesi tedavide başarı oranlarının artmasına katkı sağlayacaktır.
References
- Curran E, Stock W. How I treat acute lymphoblastic leukemia in older adolescents and young adults. Blood. 2015; 125(24): 37023710. doi: 10.1182/blood-2014-11-551481 google scholar
- Inaba H, Mullighan CG. Pediatric acute lymphoblastic leukemia. Haematologica. 2020;105(11): 2524-2539. doi: 10.3324/ haematol.2020.247031 google scholar
- National Comprehensive Cancer Network. Adolescent and Young Adult Oncology Guidelines version 2.2014. 2014;12(1) : 21-32. doi:10.6004/jnccn.2014.0004 google scholar
- ALL IC-BFM 2009 protocol. Available on: www.bialaczka.org/ wp-content/uploads/2016/10/ALLIC_BFM_2009.pdf (Accessed date: 19 May 2020). google scholar
- Rajendra A, Jain H, Bonda VNA, Nayak L, Tembhare P, Shetty D, et al. Outcomes and prognostic factors in adolescents and young adults with ALL treated with a modified BFM-90 protocol. Blood Adv. 2021;5(5):1178-1193.doi: 10.1182/bloodadvances.2020003526 google scholar
- Nakata K, Okawa S, Fuji S, Sato A, Morishima T, Tada Y, et al. Trends in survival of leukemia among children, adolescents, and young adults: A population-based study in Osaka, Japan, the Osaka Cancer Association for Children, Adolescents, Young Adults. Cancer Sci. 2021; 112(3): 1150-1160. doi: 10.1111/cas.14808 google scholar
- Ravandi F. Current management of Philadelphia chromosome positive ALL and the role of stem cell transplantation. Hematology Am Soc Hematol Educ Program. 2017;2017(1):22-27. doi: 10.1182/ asheducation-2017.1.2 google scholar
- Boissel N, Sender LS. Best Practices in Adolescent and Young Adult Patients with Acute Lymphoblastic Leukemia: A Focus on Asparaginase. Journal of Adolescent and Young Adult Oncology. 2015;4(3):118-128. doi: 10.1089/jayao.2015.0014 google scholar
- Rytting ME, Jabbour EJ, O’Brien SM, Kantarjian HM, Acute Lymphoblastic Leukemia in Adolescents and Young Adults. Cancer. 2017;123(13):2398-2403. doi:10.1002/cncr.30624 google scholar
- Ganesan P, Jain H, Bagal B, Subramanian PG, George B, Korula A, et al. Outcomes in adolescent and young adult acute lymphoblastic leukaemia: a report from the Indian Acute Leukaemia Research Database (INwARD) of the Hematology Cancer Consortium (HCC). Br J Haematol. 2021; 193(1): doi:10.1111/bjh.17268.3 google scholar
- Lofstad GE, Reinfjell T, Hestad K, Diseth TH. Cognitive Outcome in Children and Adolescents Treated for Acute Lymphoblastic Leukaemia with Chemotherapy Only. Acta Pediatrica. 2008;98(1):180-186. doi: 10.1111/j.1651-2227.2008.01055.x google scholar
- Green DM, Kawashima T, Stovall M, Leisenring W, Sklar CA, Mertenset AC, et al. Fertility of Male Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. J Clin Oncol. 2010;28(2): 332-339. doi: 10.1200/JCO.2009.24.9037 google scholar
- Shliakhtsitsava K, Romero SAD, Dewald SR, Su HI. Pregnancy and child health outcomes in pediatric and young adult leukemia and lymphoma survivors: a systematic review. Leuk Lymphoma. 2018; 59(2): 381-397. doi:10.1080/10428194.2017.1352097 google scholar
- Green DM, Sklar CA, Boice JD Jr, Mulvihill JJ, Whitton JA, Stovall M, et al. Ovarian failure and reproductive outcomes after childhood cancer treatment: results from the Childhood Cancer Survivor Study. J Clin Oncol. 2009;27(14):2374-2381. doi: 10.1200/ JCO.2008.21.1839 google scholar
- Boissel N, Baruchel A, Acute lymphoblastic leukemia in adolescent and young adults: treat as adults or as children? Blood. 2018;132(4):351-361. doi: 10.1182/blood-2018-02-778530 google scholar
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | October 24, 2023 |
| Published in Issue | Year 2023 Volume: 23 Issue: 3 |
