Hyper-CVAD Regimen in Routine Management of Adult Acute Lymphoblastic Leukemia: A Retrospective Multicenter Study

BÜYÜKAŞIK Y., Acar K., Kelkitli E., Uz B., Serefhanoglu S., Ozdemir E., ...Daha Fazla

ACTA HAEMATOLOGICA, cilt.130, sa.3, ss.199-205, 2013 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 130 Sayı: 3
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1159/000351172
  • Dergi Adı: ACTA HAEMATOLOGICA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.199-205
  • Anahtar Kelimeler: Acute lymphoblastic leukemia (adult), Acute lymphoblastic leukemia (no transplant), CALGB-8811, Chemotherapy, Hyper-CVAD, ACUTE LYMPHOCYTIC-LEUKEMIA, DOSE-INTENSIVE REGIMEN, COMPETING RISK, YOUNG-ADULTS, GROUP-B, ADOLESCENTS, TRIALS, CANCER, CYCLOPHOSPHAMIDE, CHEMOTHERAPY
  • Karadeniz Teknik Üniversitesi Adresli: Hayır

Özet

Treatment of acute lymphoblastic leukemia is unsatisfactory in adults due to disease and patient-related factors and probably because adult chemotherapy regimens are weaker than pediatric protocols. Worries about inadequacy of adult regimens urged many hematologists, including us, to reconsider their routine treatment practices. In this retrospective multicenter study, we aimed to evaluate results of hyper-CVAD treatment in comparison to other intensive protocols. All patients aged <= 65 years who were commenced on intensive induction chemotherapy between 1999 and 2011 were included in the study. Sixty-eight of 166 patients received hyper-CVAD, 65 were treated with CALGB-8811 regimen and 33 with multiple other protocols. Limited number of patients who were treated with other intensive proto-cols and mature B-acute lymphoblastic leukemia cases who were mostly given hyper-CVAD were eliminated from the statistical analyses. In spite of a favorable complete remission rate (84.2%), overall (26.3 vs. 44.2% at 5 years, p = 0.05) and disease-free (24.9 vs. 48.2%, p = 0.001) survival rates were inferior with hyper-CVAD compared to CALGB-8811 due to higher cumulative nonrelapse mortality risk (29.7 vs. 5.9%, p = 0.003) and no superiority in cumulative relapse incidence comparison (45% for both arms, p = 0.44). Hyper-CVAD, in its original form, was a less favorable regimen in our practice. Copyright (c) 2013 S. Karger AG, Basel