Phase II study of dose-adjusted EPOCH as initial therapy for adults with high-risk acute lymphoblastic leukemia

被引：5

作者：

Cassaday, Ryan D. ^{[1
,2
,7
]}

Zarling, Lucas C. ^{[1
]}

Garcia, Kelsey-Leigh A. ^{[1
]}

Sala-Torra, Olga ^{[2
]}

Stevenson, Philip A. ^{[3
]}

Martino, Christen H. ^{[1
,2
]}

Liu, Yajuan J. ^{[4
]}

Fang, Min ^{[2
,4
]}

Percival, Mary-Elizabeth M. ^{[1
,2
]}

Halpern, Anna B. ^{[1
,2
]}

Becker, Pamela S. ^{[1
,2
,5
]}

Oehler, Vivian G. ^{[1
,2
]}

Shustov, Andrei R. ^{[1
]}

Cooper, Jason P. ^{[1
,2
]}

Orozco, Johnnie J. ^{[1
,2
]}

Hendrie, Paul C. ^{[1
,2
]}

Walter, Roland B. ^{[1
,2
]}

Radich, Jerald P. ^{[1
,2
]}

Soma, Lorinda A. ^{[6
]}

Estey, Elihu H. ^{[1
,2
]}

机构：

[1] Univ Washington, Dept Med, Seattle, WA USA

[2] Fred Hutchinson Canc Ctr, Clin Res Div, Seattle, WA USA

[3] Fred Hutchinson Canc Ctr, Clin Stat Div, Seattle, WA USA

[4] Univ Washington, Dept Lab Med & Pathol, Seattle, WA USA

[5] City Hope Natl Med Ctr, Dept Hematol & Hematopoiet Cell Transplantat, Duarte, CA USA

[6] City Hope Natl Med Ctr, Dept Pathol, Duarte, CA USA

[7] Univ Washington, Dept Med, 825 Eastlake Ave,Mailstop LG 700, Seattle, WA 98109 USA

来源：

LEUKEMIA & LYMPHOMA | 2023年 / 64卷 / 05期

关键词：

Acute lymphoblastic leukemia; adult; chemotherapy; measurable residual disease; clinical trial; MINIMAL RESIDUAL DISEASE; LOW-INTENSITY CHEMOTHERAPY; HYPER-CVAD; PROGNOSTIC-SIGNIFICANCE; ELDERLY-PATIENTS; OUTCOMES; DASATINIB; REGIMEN; COMBINATION; RITUXIMAB;

D O I：

10.1080/10428194.2023.2189803

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Treatments for adults with newly-diagnosed acute lymphoblastic leukemia (ALL) may be prohibitively toxic and/or resource-intense. To address this, we performed a phase II study of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (DA-EPOCH). Imatinib or dasatinib was added for Ph + disease; rituximab was added when CD20+. Fifty-three patients were evaluable: 28 with Ph + disease, and 25 with Ph-. All patients had >= 1 high-risk clinical feature. Measurable residual disease-negativity by multiparameter flow cytometry within 4 cycles was achieved in 71% in patients with Ph + ALL and 64% in Ph - ALL. Median overall survival (OS) was 49 months, with a 2-year OS of 71%. Median relapse-free survival (RFS) in the 47 patients that attained morphologic remission was 24 months, with a 2-year RFS of 57%. Early mortality was 2%. In summary, DA-EPOCH yields deep and durable remissions in adults with ALL comparable to some resource-intense strategies but with a low rate of treatment-related death.

引用

页码：927 / 937

页数：11

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