2008, Number 6
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Gac Med Mex 2008; 144 (6)
Adolescentes con leucemia aguda linfoblástica de novo: eficacia y seguridad de un protocolo pediátrico versus uno de adultos
López-Hernández MA, Alvarado-Ibarra M, Jiménez-Alvarado RM, Diego-Flores JE, González-Avante CM
Language: Spanish
References: 18
Page: 485-490
PDF size: 47.83 Kb.
ABSTRACT
Objective: To ascertain efficacy and safety of two chemotherapy regimens, one designed for adults and the other one for children, in adolescent patients with acute lymphoblastic leukemia (ALL).
Methods: Between 2001-2006, we included patients aged 15-25, with de novo, Phi(-) ALL, without initial central nervous system (CNS) infiltration . Twenty patients received a chemotherapy regimen designed for children with high-risk ALL (LALIN) and twenty a regimen for adults (LALA). Both were intensive and included dexamethasone, daunorubicin, cyclophosphamide, vincristine, cytarabine, methotrexate and mercaptopurine as well as CNS prophylaxis. Elective suspension of chemotherapy occurred at two and three years respectively, in patients with continued complete remission.
Results: Patients in both groups were comparable in age, sex, presence and size of hepatosplenomegaly, initial leukocytes and platelet counts. Predominant in both groups was L2 morphology and B-cell CD10(+) immunophenotype. Results for the LALIN/ LALA groups were: failures 2/0 (p=0.49); relapses 0/4 (p=0.05); therapy associated deaths 4/7 (p=0.48); and event free survival at 70 months follow-up was 70% and 40% (p=0.12).
Conclusions: In patients aged 15-25, with de novo ALL, a chemotherapy regimen designed for children had significantly less relapses, than adult regimen. We saw no increase in toxicity in the LALIN versus the LALA group.
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