Pediatric Regimen Beats Adult Chemo for Young Adults With ALL

Lower mortality, improved remission and event-free survival rates, lower relapse rates

MONDAY, April 23 (HealthDay News) -- Adolescent and young adult patients with acute lymphoblastic leukemia (ALL) who are treated with pediatric-inspired regimens exhibit lower all-cause mortality, higher complete remission and event-free survival rates, and lower relapse rates compared with those treated with conventional adult-chemotherapy regimens, according to a study published in the May issue of the American Journal of Hematology.

Ron Ram, M.D., of Tel-Aviv University in Israel, and colleagues conducted a systematic review and meta-analysis of 11 published comparative studies reporting results from 2,489 adolescent and young adult patients, aged 16 to 39 years, with ALL. The safety and efficacy of pediatric-inspired induction chemotherapy regimens were compared with conventional-adult chemotherapy.

The researchers found that all-cause mortality at three years was significantly lower for adolescent and young adult patients treated with pediatric-inspired chemotherapy compared with conventional-adult chemotherapy regimens (relative risk [RR], 0.58). Those treated with pediatric-inspired regimens had superior complete remission rates after induction chemotherapy (RR, 1.05; 95 percent confidence interval, 1.01 to 1.10) and improved event-free survival (RR, 1.66). Although nonrelapse mortality was similar between the two groups, the relapse rate was significantly lower in pediatric-inspired regimen-treated adolescents and young adults (RR, 0.51).

"Pediatric-inspired regimens are superior to conventional-adult chemotherapy in adolescent and young adult ALL patients," the authors write. "Further randomized controlled studies to investigate this approach in adult ALL patients are warranted.

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