International Journal of Hematology

, Volume 92, Issue 3, pp 490–502 | Cite as

Intensified consolidation therapy with dose-escalated doxorubicin did not improve the prognosis of adults with acute lymphoblastic leukemia: the JALSG-ALL97 study

  • Itsuro Jinnai
  • Tohru Sakura
  • Motohiro Tsuzuki
  • Yasuhiro Maeda
  • Noriko Usui
  • Masayuki Kato
  • Hirokazu Okumura
  • Taiichi Kyo
  • Yasunori Ueda
  • Yuji Kishimoto
  • Fumiharu Yagasaki
  • Kosuke Tsuboi
  • Shigeo Horiike
  • Jin Takeuchi
  • Masako Iwanaga
  • Yasushi Miyazaki
  • Shuichi Miyawaki
  • Kazunori Ohnishi
  • Tomoki Naoe
  • Ryuzo Ohno
Original Article

Abstract

We designed a treatment protocol for newly diagnosed adult acute lymphoblastic leukemia (ALL) in the pre-imatinib era, employing intensified consolidation therapy with a total of 330 mg/m2 doxorubicin and adopting slightly modified induction and maintenance regimen of the CALGB 8811 study. Of 404 eligible patients (median age 38 years, range 15–64 years), 298 (74%) achieved complete remission (CR). The 5-year overall survival (OS) rate was 32%, and the 5-year disease-free survival (DFS) rate was 33%. Of 256 Philadelphia chromosome (Ph)-negative patients, 208 (81%) achieved CR and the 5-year OS rate was 39%, and 60 of them underwent allogeneic-hematopoietic stem cell transplantation (allo-HSCT) from related or unrelated donors during the first CR, resulting in 63% 5-year OS. Of 116 Ph-positive patients, 65 (56%) achieved CR and the 5-year OS rate was 15%, and 22 of them underwent allo-HSCT from related or unrelated donors during the first CR, resulting in 47% 5-year OS. In Ph-negative patients, multivariate analysis showed that older age, advanced performance status and unfavorable karyotypes were significant poor prognostic factors for OS and higher WBC counts for DFS. The present treatment regimen could not show a better outcome than that of our previous JALSG-ALL93 study for adult ALL.

Keywords

Acute lymphoblastic leukemia A multiinstitutional trial Doxorubicin Prognostic factors The Japan Adult Leukemia Study Group (JALSG) 

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Copyright information

© The Japanese Society of Hematology 2010

Authors and Affiliations

  • Itsuro Jinnai
    • 1
    • 2
  • Tohru Sakura
    • 3
  • Motohiro Tsuzuki
    • 4
  • Yasuhiro Maeda
    • 5
  • Noriko Usui
    • 6
  • Masayuki Kato
    • 7
  • Hirokazu Okumura
    • 8
  • Taiichi Kyo
    • 9
  • Yasunori Ueda
    • 10
  • Yuji Kishimoto
    • 11
  • Fumiharu Yagasaki
    • 2
  • Kosuke Tsuboi
    • 12
  • Shigeo Horiike
    • 13
  • Jin Takeuchi
    • 14
  • Masako Iwanaga
    • 15
  • Yasushi Miyazaki
    • 15
  • Shuichi Miyawaki
    • 16
  • Kazunori Ohnishi
    • 17
  • Tomoki Naoe
    • 18
  • Ryuzo Ohno
    • 19
  1. 1.Department of Health EvaluationOgawa Red Cross HospitalSaitamaJapan
  2. 2.Department of Hematology, International Medical CenterSaitama Medical UniversityHidakaJapan
  3. 3.Department of HematologyMaebashi Saiseikai HospitalMaebashiJapan
  4. 4.Department of Internal MedicineFujita Health University School of MedicineToyoakeJapan
  5. 5.Division of HematologyKinki University School of MedicineOsaka-SayamaJapan
  6. 6.Department of Clinical Oncology and HematologyJikei University School of MedicineTokyoJapan
  7. 7.Division of Hematology and OncologySt. Marianna University School of MedicineKawasakiJapan
  8. 8.Department of HematologyKanazawa University Graduate School of Medical ScienceKanazawaJapan
  9. 9.Department of 4th Internal MedicineHiroshima Red Cross HospitalHiroshimaJapan
  10. 10.Department of Hematology/OncologyKurashiki Central HospitalKurashikiJapan
  11. 11.Department of HematologyKansai Medical UniversityHirakataJapan
  12. 12.Department of Hematology/OncologyTokai University School of MedicineIseharaJapan
  13. 13.Division of Hematology and Oncology, Department of MedicineKyoto Prefectural University of MedicineKyotoJapan
  14. 14.Department of Hematology and RheumatologyNihon University School of MedicineTokyoJapan
  15. 15.Department of Molecular Medicine and HematologyNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
  16. 16.Division of HematologyTokyo Metropolitan Ohtsuka HospitalTokyoJapan
  17. 17.Department of Internal Medicine IIIHamamatsu University School of MedicineHamamatsuJapan
  18. 18.Department of Hematology/OncologyNagoya University Graduate School of MedicineNagoyaJapan
  19. 19.Aichi Shukutoku UniversityNagoyaJapan

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