Journals / Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi / 2022 / Volume: 9 Issue: 3

Higher Survival Advantage with Hyper-CVAD Chemotherapy Regimen Before Allogeneic Stem Cell Transplantation in Patients with High Risk Adult Acute Lymphoblastic Leukemia: Two-Center Experience

Emrah Kılıçaslan(Division of Hematology, Department of Internal Medicine, Istanbul Medeniyet University, Faculty of Medicine)0000-0002-0944-4068
Selim Sayın(Division of Hematology, Department of Internal Medicine, Health Sciences University Gulhane School of Medicine)0000-0002-7197-6890
Murat Yıldırım(Division of Hematology, Department of Internal Medicine, Health Sciences University Gulhane School of Medicine)0000-0001-6416-9575
Tayfun Elibol(Division of Hematology, Department of Internal Medicine, Istanbul Medeniyet University, Faculty of Medicine)0000-0001-8738-5246
Hilmi Gözden(Division of Hematology, Department of Internal Medicine, Health Science University, Sultan Abdulhamid Han Training and Research Hospital)0000-0002-4194-007X
Meltem Aylı(Division of Hematology, Department of Internal Medicine, Health Sciences University Gulhane School of Medicine)0000-0001-5766-5642
Muhammet Kaptan(Division of Hematology, Department of Internal Medicine, Health Science University, Sultan Abdulhamid Han Training and Research Hospital)0000-0002-7335-2133
Pages
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Publication Date
2022-12-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In all (n=30) patients treated with Hyper-CVAD, complete response (CR) rate was 86.7%, induction mortality was 10%, refractory disease was 3.3%, the median overall survival (OS) was 38 months (95% CI 7.78–68.2 months), the median disease-free survival (DFS) was 29 months (95% CI 9–49 months), the 2-year OS rate was 56.5%, and the 2-year DFS was rate 56.7%.

📌 3 Key Takeaways

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Objective & Hypothesis:While promising results have been achieved in the treatment of childhood, the optimal initial treatment for adult acute lymphoblastic leukemia (ALL) has not yet been defined.
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Key Findings & Data:Hyper-CVAD has become a widely used treatment for approximately 2 decades in the treatment of adult ALL.
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Conclusion & Impact:In all (n=30) patients treated with Hyper-CVAD, complete response (CR) rate was 86.7%, induction mortality was 10%, refractory disease was 3.3%, the median overall survival (OS) was 38 months (95% CI 7.78–68.2 months), the median disease-free survival (DFS) was 29 months (95% CI 9–49 months), the 2-year OS rate was 56.5%, and the 2-year DFS was rate 56.7%.
🔬Design:Research Article
📍Scope:2014 Verileri
⚙️Variables:Hyper-CVAD · Acute lymphoblastic leukemia · Adult

Abstract

While promising results have been achieved in the treatment of childhood, the optimal initial treatment for adult acute lymphoblastic leukemia (ALL) has not yet been defined. Hyper-CVAD has become a widely used treatment for approximately 2 decades in the treatment of adult ALL. We conducted a retrospective analysis of 30 patients treated with Hyper-CVAD at two centers between 2014 and 2020. In all (n=30) patients treated with Hyper-CVAD, complete response (CR) rate was 86.7%, induction mortality was 10%, refractory disease was 3.3%, the median overall survival (OS) was 38 months (95% CI 7.78–68.2 months), the median disease-free survival (DFS) was 29 months (95% CI 9–49 months), the 2-year OS rate was 56.5%, and the 2-year DFS was rate 56.7%. For standard risk (n=12) ALL patients, the median OS was 20 months (95% CI 0–43 months), and median DFS was 7 months (95% CI 0–25 months). For high risk (n=18) ALL patients, the median OS was 38 months (95% CI 0–76 months), and median DFS was not reached. These results indicate that Hyper-CVAD regimen should be considered as an option for induction treatment of adult ALL patients who are newly diagnosed and eligible for allo-HSCT.

Özet

Çocukluk çağı akut lenfoblastik lösemi (ALL) tedavisinde umut verici sonuçlar elde edilirken, yetişkin için optimal indüksiyon tedavisi henüz belirlenememiştir. Hyper-CVAD kemoterapi rejimi, yetişkin ALL tedavisinde yaklaşık yirmi yıldır yaygın olarak kullanılan bir tedavi haline gelmiştir. 2014 ve 2020 yılları arasında iki merkezde Hyper-CVAD rejimi ile tedavi edilen 30 hastanın retrospektif analizini gerçekleştirdik. Hyper-CVAD ile tedavi edilen hastalarda (n=30), tam yanıt oranı (TY) %86.7, indüksiyon mortalitesi %10, refrakter hastalık %3.3, medyan genel sağkalım (GS) 38 ay (%95 CI 7.78-68.2 ay), medyan hastalıksız sağkalım (HS) 29 ay (% 95 CI 9-49 ay), 2 yıllık GS oranı % 56.5 ve 2 yıllık HS oranı % 56.7 olarak saptadık. Standart risk (n=12) ALL hastalar için, medyan GS 20 ay (%95 CI 0-43 ay) ve medyan HS 7 ay (%95 CI 0-25 ay) saptadık. Yüksek riskli (n=18) ALL hastalar için, medyan GS 38 ay iken (%95 CI 0-76 ay), medyan HS’a ulaşılamadı. Bu sonuçlar, Hyper-CVAD rejiminin yeni tanı konmuş ve allojenik kök hücre transplantasyonu için uygun olan ALL hastalarının indüksiyon tedavisi için bir seçenek olarak değerlendirilmesi gerektiğini göstermektedir.

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Cite This Article

Kılıçaslan, E., Sayın, S., Yıldırım, M., Aylı, M. (2022). Higher Survival Advantage with Hyper-CVAD Chemotherapy Regimen Before Allogeneic Stem Cell Transplantation in Patients with High Risk Adult Acute Lymphoblastic Leukemia: Two-Center Experience. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, Volume: 9 Issue: 3. https://doi.org/10.47572/muskutd.930925

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