Hyper-CVAD和改良CALGB-10403方案治疗成人费城阴性急性淋巴细胞白血病的比较研究

IF 2.3 3区医学 Q2 HEMATOLOGY

European Journal of Haematology Pub Date : 2025-01-07 DOI:10.1111/ejh.14381

Jessica Zalapa-Soto, Fausto Alfredo Rios-Olais, Lyam Carlo Chacón-Rangel, Analy Mora-Cañas, Mario Meza-Meza, Juan Rangel-Patiño, Roberta Demichelis-Gómez

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引用次数: 0

摘要

目的：急性淋巴细胞白血病（ALL）在拉丁美洲发病率较高，成年患者的长期预后较差，尽管完全缓解（CR）率很高。当采用成人方案治疗时，3年总生存率（OS）约为20%。然而，采用儿科激励方案（PIRs）已显示出改善的结果。方法：我们对2015年1月至2023年5月期间接受PIR、改良CALGB 10403 （mCALGB）或Hyper-CVAD成人方案治疗的新诊断ph阴性ALL西班牙裔成年患者进行了比较分析。主要终点为OS，次要终点为无复发生存期（RFS）。结果：我们纳入了100例患者，其中35例接受Hyper-CVAD治疗，65例接受mCALGB治疗。中位年龄为26岁（20.2-38岁）。中位生存期为54.2个月（95% CI 28.3-80.1）， mCALGB组未达到中位生存期（95% CI NR-NR），而Hyper-CVAD组为22.4个月（95% CI 13.7-31）。3年OS分别为64.9%和34.9%,p = 0.034。mCALGB治疗与OS （HR 0.29, 95% CI 0.13-0.66, p = 0.003）和RFS （HR 0.29, 95% CI 0.14-0.59, p）独立相关。结论：与Hyper-CVAD相比，mCALGB治疗与RFS和OS的获益独立相关。

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Hyper-CVAD and Modified CALGB-10403 Regimens in Adult Patients With Philadelphia-Negative Acute Lymphoblastic Leukemia: A Comparative Study.

Objective: Acute lymphoblastic leukemia (ALL) has a higher incidence in Latin America, with adult patients experiencing worse long-term outcomes despite high complete remission (CR) rates. When treated with adult regimens, 3-year overall survival (OS) is approximately 20%. However, adopting pediatric-inspired regimens (PIRs) has shown improved outcomes.

Methods: We performed a comparative analysis of Hispanic adult patients with newly diagnosed Ph-negative ALL, treated with either a PIR, a modified CALGB 10403 (mCALGB), or the adult regimen Hyper-CVAD between January 2015 and May 2023. The primary endpoint was OS and among secondary endpoints relapse-free survival (RFS).

Results: We included 100 patients, 35 were treated with Hyper-CVAD and 65 with mCALGB. Median age was 26 years (range, 20.2-38). The median OS was 54.2 months (95% CI 28.3-80.1), with a non-reached median OS in the mCALGB group (95% CI NR-NR) versus 22.4 months (95% CI 13.7-31) for Hyper-CVAD. The 3-year OS was 64.9% versus 34.9%, p = 0.034. Treatment with mCALGB was independently associated with OS (HR 0.29, 95% CI 0.13-0.66, p = 0.003) and RFS (HR 0.29, 95% CI 0.14-0.59, p < 0.001).

Conclusions: Treatment with mCALGB was independently associated with benefits regarding RFS and OS when compared to Hyper-CVAD.

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来源期刊

European Journal of Haematology 医学-血液学

CiteScore

5.50

自引率

0.00%

发文量

168

审稿时长

4-8 weeks

期刊介绍： European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.