Pediatric-inspired therapy vs non-intensive therapy in Ph-negative acute lymphoblastic leukemia patients aged 55-65 years

This study aimed to compare pediatric-inspired intensive therapy and non-intensive therapy for older patients with acute lymphoblastic leukemia.

This study concluded that pediatric-inspired intensive therapy improves the outcome for these patients when compared to the non-intensive therapy.

Acute lymphoblastic leukemia (ALL) in younger adults has recently been treated with pediatric inspired intensive therapy regimens. These intensive regimens include the use of continuous high-dose chemotherapy and high doses of non-myelotoxic drugs (not suppressing bone marrow).  This pediatric inspired regimen has been tested in adults ranging from 30 to 55 years of age. However there has been little testing in adults aged older than 55 years and is a lack of information on the outcomes for these patients.  

It was not known if the intensive or non-intensive therapy would be more effective for older patients with ALL.

This study involved patients aged 55 to 65 years who had Ph-negative ALL. 67 patients received pediatric-inspired intensive treatment (PI group) and 44 patients received semi-intensive treatment (SI group). The treatments were compared. The PI group was followed for an average of 49 months. The SI group was followed for an average of 21 months.

The PI group had a complete remission (no cancer left) rate of 85% compared to 64% in the SI group. The PI group had a 39% cumulative incidence of relapse (cancer returns) compared to 60% in the SI group. The PI group had a 28% cumulative incidence of treatment-related mortality compared to 21% in the SI group. The PI group had a rate of 37% for event free survival (time from treatment until relapse or death) at 2 years compared to 21% in the SI group.

This study concluded that PI treatment improves the outcome for older adults with ALL when compared to SI treatment.

Consult your physician about both SI and PI treatment options.