Effect of Adults and Pediatric-Inspired Schemes on Negative Measurable Residual Disease and Overall Survival in Adults with Acute Lymphoblastic Leukemia: A Retrospective Analysis from the Hematology Department at Hospital Regional de Alta Especialidad de Ixtapaluca, Mexico.

Abstract

Introduction: The treatment for acute lymphoblastic leukemia (ALL) is based upon combining chemotherapy, tyrosine kinase inhibitors, and bispecific monoclonal antibodies. Screening throughout the measurable residual disease is the main tool to establish the prognosis and risk of relapse. Induction protocols include a combination of steroids, anthracyclines, vinca alkaloids, and, in the pediatric-inspired schemes, asparaginase.

Methods: A retrospective study included clinical records of patients with ALL who received treatment based on Hyper-CVAD (adult scheme) or CALGB10403 (pediatric scheme) between 2018 and 2023.

Results: A total of 460 clinical records of patients were collected. 50.2% were male. The average age was 34 years old. 20.7% (n = 95) received the pediatric scheme, while 79.3% (n = 365) received the adult scheme. Pediatric scheme patients presented a higher ratio of complete remissions (67.4%) than adult scheme (57.3%) (p = 0.047). When comparing survival according to groups, pediatric scheme patients presented higher survival rates than adult patients (log rank 0.000).

Conclusions: The introduction of bearable and accessible schemes with the choice of outpatient administration is ideal for the health systems of Latin America. Along with the treatment selection, strict screening through a standardized technique remains the main prognosis factor for the treatment of adult ALL.