In a nutshell
This study aimed to investigate if a modified Berlin-Frankfurt-Münster (BFM) regimen would be a safe and effective method of treatment for adult patients with newly diagnosed acute lymphoblastic leukemia (ALL).
This study concluded that this regimen is well tolerated and effective in these patients.
Some background
Berlin-Frankfurt-Münster (BFM) regimen is a treatment that can be used for leukemia. The BFM regimen involves different chemotherapy drugs at different doses. The stages involved are induction, protocol, re-induction, and maintenance.
There is no standard defined treatment for adults with acute lymphoblastic leukemia (ALL). It was not known if a modified BFM regimen would be safe and effective for adults with newly diagnosed standard-risk ALL.
Methods & findings
This study involved 46 patients with newly diagnosed standard-risk ALL. All patients were treated with a modified BFM regimen. They were followed-up for an average of 34 months.
The complete hematologic remission rate was 91.3%. Hematologic remission relates to normal levels of blood cell counts. The complete molecular remission rate was 76.1%. Molecular remission relates to no BCR-ABL gene (cancer gene) present in the blood.
The 5-year event-free survival (EFS; no major complications due to leukemia) rate was 58%. The 5-year overall survival (OS) rate was 66.7%.
No patient who achieved complete remission presented with central nervous system (CNS) involvement. CNS involvement includes neurological symptoms or high white blood cell count in cerebrospinal fluid (the liquid found in the brain and spinal cord).
Minimal residual disease positive status (some cancer left) was an unfavorable factor for EFS and OS. A time interval between induction and protocol treatment of more than 70 days was also an unfavorable factor for EFS and OS.
During induction, there were one or more cases of severely decreased bone marrow activity. This can lead to fewer white blood cells, red blood cells, and platelets. No toxicity-related deaths were observed.
The bottom line
This study concluded that the modified BFM regimen is well tolerated and effective in patients with standard-risk ALL.
The fine print
This study only included Chinese patients. Also, the number of participants was small. Further studies involving other ethnicities are needed.
Published By :
International journal of hematology
Date :
Jul 18, 2019
