Maria Agustina Perusini, Claire Andrews, Eshetu G Atenafu, Vikas Gupta, Dawn Maze, Andre C Schuh, Karen Wl Yee, Aniket Bankar, Marta B Davidson, Guillaume Richard-Carpentier, Steven M Chan, Jad Sibai, Aaron D Schimmer, Mark D Minden, Hassan Sibai
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引用次数: 0
摘要
这份回顾性报告介绍了对73名年龄在60岁或以上的费城染色体阴性急性淋巴细胞白血病(Ph阴性ALL)患者进行治疗后观察到的结果和不良事件(AEs),这些患者均接受了结合了聚乙二醇天冬酰胺酶(PEG-ASP)或原生天冬酰胺酶(EC-ASP)的儿科启发方案治疗。值得注意的是,61%的患者出现了严重程度为III-IV级的AEs。最常见的不良反应包括血栓形成(35.6%)、发热性中性粒细胞减少(38.4%)和转氨酶炎(34.2%)。在总生存率、无白血病生存率或早期死亡率方面,AEs 并未转化为显著差异。此外,与之前的数据相比,我们观察到早期死亡率有所下降(11% 对 20%),中位总生存期有所延长(54 个月对 48 个月)。这些研究结果表明,对于年龄较大的噬菌体阴性 ALL 患者来说,使用儿科启发化疗方案 ASP 是一种有效且耐受性良好的治疗选择。不过,这也强调了在整个治疗过程中勤于监测和密切随访的重要性。
Outcomes and adverse events in older acute lymphoblastic Leukemia patients treated with a pediatric-inspired protocol with Pegylated or native Asparaginase.
This retrospective report presents the outcomes and adverse events (AEs) observed in 73 patients aged 60 years or older diagnosed with Philadelphia Chromosome-negative Acute Lymphoblastic Leukemia (Ph-negative ALL) treated with a pediatric-inspired protocol incorporating either Pegylated (PEG-ASP) or Native Asparaginase (EC-ASP). Notably, 61% of patients experienced AEs of Grade III-IV severity. The most prevalent AEs included thrombosis (35.6%), febrile neutropenia (38.4%), and transaminitis (34.2%). AEs did not translate into significant differences concerning overall survival, leukemia-free survival, or early mortality. Furthermore, we observed a reduction in early mortality rates (11% vs. 20%) and an increase in median overall survival (54 vs. 48 months) compared to our previous data. These findings suggest that the utilization of a pediatric-inspired chemotherapy protocol, with ASP, is an effective and well-tolerated therapeutic option for older patients with Ph-negative ALL. However, it emphasizes the importance of diligent monitoring and close follow-up throughout treatment.
期刊介绍:
Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.