PMID- 24443846
OWN - NLM
STAT- MEDLINE
DCOM- 20141201
LR  - 20151119
IS  - 1600-0609 (Electronic)
IS  - 0902-4441 (Linking)
VI  - 92
IP  - 5
DP  - 2014
TI  - High relapse rate of T cell acute lymphoblastic leukemia in adults treated with 
      Hyper-CVAD chemotherapy in Sweden.
PG  - 377-81
LID - 10.1111/ejh.12269 [doi]
AB  - BACKGROUND: Hyper-CVAD is widely used to treat acute lymphoblastic leukemia (ALL) 
      and aggressive lymphomas. This multicenter, population-based study assessed the 
      efficacy of Hyper-CVAD as first-line therapy in patients with T-cell ALL (T-ALL). 
      PATIENTS AND METHODS: Between October 2002 and September 2006, 24 patients were 
      diagnosed with T-ALL in Sweden; 19 were eligible for treatment with the protocol. 
      RESULTS: The median age was 32 yr (range 18-72 yr). Complete remission (CR) was 
      obtained in 17 of 19 (89%) patients, and the treatment was relatively well 
      tolerated. Allogeneic stem cell transplantation (SCT) was recommended in 
      high-risk disease and was performed in four patients upfront. Two- and 5-yr 
      leukemia-free survivals (LFS) in 17 patients with CR achievement were identical, 
      at 29% (95% confidence interval [CI]: 8-51). Two- and 5-yr overall survival (OS) 
      in whole cohort was 63% (95% CI: 42-85) and 47% (95% CI: 26-69), respectively. 
      The 5-yr LFS for 15 patients who did not receive allogeneic SCT upfront were 20% 
      (95% CI: 0-40), although 14 of 15 completed the protocol (eight cycles). Relapse 
      occurred in 2 of 4 upfront-transplanted patients and in 12 of 15 patients treated 
      with chemotherapy alone, six of whom received allogeneic SCT in CR2. Age >/=35 yr 
      influenced OS negatively in univariate analysis (HR 5.1, 95% CI: 1.55-16.7). 
      CONCLUSIONS: Hyper-CVAD treatment resulted in a high CR rate and appeared safe, 
      but it showed poor efficacy at preventing relapse. Therefore, this treatment is 
      no longer recommended for adults with T-ALL in Sweden.
CI  - (c) 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Kozlowski, Piotr
AU  - Kozlowski P
AD  - Hematology Section, Department of Medicine, Orebro University Hospital, Orebro, 
      Sweden.
FAU - Astrom, Maria
AU  - Astrom M
FAU - Ahlberg, Lucia
AU  - Ahlberg L
FAU - Bernell, Per
AU  - Bernell P
FAU - Hulegardh, Erik
AU  - Hulegardh E
FAU - Hagglund, Hans
AU  - Hagglund H
FAU - Karlsson, Karin
AU  - Karlsson K
FAU - Markuszewska-Kuczymska, Alicja
AU  - Markuszewska-Kuczymska A
FAU - Tomaszewska-Toporska, Beata
AU  - Tomaszewska-Toporska B
FAU - Smedmyr, Bengt
AU  - Smedmyr B
FAU - Amini, Rose-Marie
AU  - Amini RM
FAU - Hallbook, Helene
AU  - Hallbook H
CN  - Swedish Adult ALL Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20140221
PL  - England
TA  - Eur J Haematol
JT  - European journal of haematology
JID - 8703985
RN  - 04079A1RDZ (Cytarabine)
RN  - 5J49Q6B70F (Vincristine)
RN  - 80168379AG (Doxorubicin)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - 9842X06Q6M (Betamethasone)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - *Antineoplastic Combined Chemotherapy Protocols
MH  - Betamethasone/administration & dosage
MH  - Cyclophosphamide/administration & dosage
MH  - Cytarabine/administration & dosage
MH  - Doxorubicin/administration & dosage
MH  - Female
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Male
MH  - Methotrexate/administration & dosage
MH  - Middle Aged
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality/pathology/*therapy
MH  - Recurrence
MH  - Remission Induction
MH  - Survival Analysis
MH  - Sweden
MH  - Transplantation, Homologous
MH  - Vincristine/administration & dosage
OTO - NOTNLM
OT  - antineoplastic combined chemotherapy protocols
OT  - precursor T-cell lymphoblastic leukemia-lymphoma
OT  - stem cell transplantation
OT  - treatment outcome
EDAT- 2014/01/22 06:00
MHDA- 2014/12/15 06:00
CRDT- 2014/01/22 06:00
PHST- 2014/01/13 00:00 [accepted]
PHST- 2014/01/22 06:00 [entrez]
PHST- 2014/01/22 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
AID - 10.1111/ejh.12269 [doi]
PST - ppublish
SO  - Eur J Haematol. 2014;92(5):377-81. doi: 10.1111/ejh.12269. Epub 2014 Feb 21.