Pediatric-Like Acute Lymphoblastic Leukemia Therapy in Adults With Lymphoblastic Lymphoma: The GRAALL-LYSA LL03 Study - Archive ouverte HAL Access content directly
Journal Articles Journal of Clinical Oncology Year : 2016

Pediatric-Like Acute Lymphoblastic Leukemia Therapy in Adults With Lymphoblastic Lymphoma: The GRAALL-LYSA LL03 Study

(1) , (2) , (3, 4) , (5) , (6, 7) , (8) , (9) , (10) , (11) , (12) , (10) , (13) , (14) , (4) , (15) , (10) , (1) , (1) , (16) , (2) , (7, 6) , (2) , (17)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Thierry Lamy
  • Function : Author
  • PersonId : 946359
Patrice Chevallier
  • Function : Author
  • PersonId : 988133
Anne Moreau
  • Function : Author
  • PersonId : 1202589
Elizabeth Macintyre
  • Function : Author
  • PersonId : 902525
Hervé Dombret

Abstract

PURPOSE: This study evaluated the efficacy of pediatric-like acute lymphoblastic leukemia (ALL) therapy in adults with lymphoblastic lymphoma (LL). PATIENTS AND METHODS: This was a prospective phase II study in adults 18 to 59 years old with previously untreated LL. Patients were treated with an adapted pediatric-like ALL protocol, which included a corticosteroid prephase, a five-drug induction reinforced by sequential cyclophosphamide administration, dose-dense consolidation, late intensification, CNS prophylaxis, and a 2-year maintenance phase. Treatment response was assessed by computed tomography and optional positron emission tomography. Allogeneic hematopoietic stem cell transplant was offered to selected patients in first complete remission (CR) or unconfirmed CR. RESULTS: The study enrolled 148 patients (131 with T-lineage LL [T-LL] and 17 with B-lineage LL [B-LL]). A total of 119 patients with T-LL (90.8%) and 13 with B-LL (76.5%) reached CR/unconfirmed CR, including 26 with T-LL and two with B-LL who needed a second induction salvage course. Relapse occurred in 34 patients with T-LL and four with B-LL. In patients with T-LL, 3-year event-free survival was 63.3% (95% CI, 54.2% to 71.0%), disease-free survival was 72.4% (95% CI, 63.0% to 79.7%), and overall survival was 69.2% (95% CI, 60.0% to 76.7%). Multivariate analysis identified serum lactate dehydrogenase level and the NOTCH1/FBXW7/RAS/PTEN oncogene (a four-gene oncogenetic classifier) status but not positron emission tomography or hematopoietic stem cell transplant as independent prognostic factors for outcome in T-LL. CONCLUSION: In adults with LL, an intensive pediatric-like ALL treatment protocol was associated with a good response rate and outcome. In patients with T-LL, the four-gene oncogenetic classifier and lactate dehydrogenase level were independent prognostic indicators.
Fichier principal
Vignette du fichier
2016FLepretreJClinOncolEq7A.pdf (872.77 Ko) Télécharger le fichier
Origin : Files produced by the author(s)
Loading...

Dates and versions

inserm-01411210 , version 1 (07-12-2016)

Identifiers

Cite

Stéphane Leprêtre, Aurore Touzart, Thomas Vermeulin, Jean-Michel Picquenot, Aline Schmidt-Tanguy, et al.. Pediatric-Like Acute Lymphoblastic Leukemia Therapy in Adults With Lymphoblastic Lymphoma: The GRAALL-LYSA LL03 Study. Journal of Clinical Oncology, 2016, 34 (6), pp.572. ⟨10.1200/JCO.2015.61.5385⟩. ⟨inserm-01411210⟩
1451 View
801 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More