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Prognostic Factors in Adult Acute Lymphoblastic Leukemia (ALL)

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Adult Acute Lymphocytic Leukemia

Part of the book series: Contemporary Hematology ((CH))

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Abstract

The treatment of adults with ALL, although not offering the same satisfactory long-term disease-free survivals (DFS) as is afforded to the majority of children, has improved steadily over the past decades. Outcomes have improved for all adult age groups except for the over sixties [1]. Treating physicians are very much aware that age has, arguably, the most significant impact on outcome. To what extent that relates to the changing biology of the disease with age, per se, or whether it results from a different approach to – or tolerance of – therapy is unclear.

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References

  1. Pulte, D., Gondos, A., & Brenner, H. (2009). Improvement in survival in younger patients with acute lymphoblastic leukemia from the 1980s to the early 21st century. Blood, 113(7), 1408–1411.

    Article  PubMed  CAS  Google Scholar 

  2. Rowe, J. M., Buck, G., Burnett, A. K., et al. (2005). Induction therapy for adults with acute lymphoblastic leukemia: Results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993. Blood, 106, 3760–3767.

    Article  PubMed  CAS  Google Scholar 

  3. Hoelzer, D., Thiel, E., Loffler, H., et al. (1988). Prognostic factors in a multicenter study for treatment of acute lymphoblastic leukemia in adults. Blood, 71, 123–131.

    PubMed  CAS  Google Scholar 

  4. Chessells, J. M., Hall, E., Prentice, H. G., Durrant, J., Bailey, C. C., & Richards, S. M. (1998). The impact of age on outcome in lymphoblastic leukaemia; MRC UKALL X and XA compared: A report from the MRC Paediatric and Adult Working Parties. Leukemia, 12, 463–473.

    Article  PubMed  CAS  Google Scholar 

  5. Moorman, A. V., Harrison, C. J., Buck, G. A., et al. (2007). Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): Analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial. Blood, 109, 3189–3197.

    Article  PubMed  CAS  Google Scholar 

  6. Jones, L. K., & Saha, V. (2005). Philadelphia positive acute lymphoblastic leukaemia of childhood. British Journal Haematology, 130, 489–500.

    Article  Google Scholar 

  7. Pui, C. H., & Evans, W. E. (2006). Treatment of acute lymphoblastic leukemia. The New England Journal of Medicine, 354, 166–178.

    Article  PubMed  CAS  Google Scholar 

  8. Boissel, N., Auclerc, M. F., Lheritier, V., et al. (2003). Should adolescents with acute lymphoblastic leukemia be treated as old children or young adults? Comparison of the French FRALLE-93 and LALA-94 trials. Journal of Clinical Oncology, 21, 774–780.

    Article  PubMed  Google Scholar 

  9. Ramanujachar, R., Richards, S., Hann, I., & Webb, D. (2006). Adolescents with acute lymphoblastic leukaemia: Emerging from the shadow of paediatric and adult treatment protocols. Pediatric Blood & Cancer, 47, 748–756.

    Article  Google Scholar 

  10. de Bont, J. M., Holt, B., Dekker, A. W., van der Does-van den Berg, A., Sonneveld, P., & Pieters, R. (2004). Significant difference in outcome for adolescents with acute lymphoblastic leukemia treated on pediatric vs adult protocols in the Netherlands. Leukemia, 18, 2032–2035.

    Article  PubMed  Google Scholar 

  11. Hallbook, H., Gustafsson, G., Smedmyr, B., Soderhall, S., & Heyman, M. (2006). Treatment outcome in young adults and children >10 years of age with acute lymphoblastic leukemia in Sweden: A comparison between a pediatric protocol and an adult protocol. Cancer, 107, 1551–1561.

    Article  PubMed  Google Scholar 

  12. Stock, W., La, M., Sanford, B., et al. (2008). What determines the outcomes for adolescents and young adults with acute lymphoblastic leukemia treated on cooperative group protocols? A comparison of Children’s Cancer Group and Cancer and Leukemia Group B studies. Blood, 112, 1646–1654.

    Article  PubMed  CAS  Google Scholar 

  13. Ramanujachar, R., Richards, S., Hann, I., et al. (2007). Adolescents with acute lymphoblastic leukaemia: Outcome on UK national paediatric (ALL97) and adult (UKALLXII/E2993) trials. Pediatric Blood & Cancer, 48, 254–261.

    Article  Google Scholar 

  14. Ribera, J. M., Oriol, A., Sanz, M. A., et al. (2008). Comparison of the results of the treatment of adolescents and young adults with standard-risk acute lymphoblastic leukemia with the Programa Espanol de Tratamiento en Hematologia pediatric-based protocol ALL-96. Journal of Clinical Oncology, 26, 1843–1849.

    Article  PubMed  CAS  Google Scholar 

  15. Goldstone, A. H., Richards, S. M., Lazarus, H. M., et al. (2008). In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: Final results of the International ALL Trial (MRC UKALL XII/ECOG E2993). Blood, 111, 1827–1833.

    Article  PubMed  CAS  Google Scholar 

  16. Boucheix, C., David, B., Sebban, C., et al. (1994). Immunophenotype of adult acute lymphoblastic leukemia, clinical parameters, and outcome: An analysis of a prospective trial including 562 tested patients (LALA87). French Group on Therapy for Adult Acute Lymphoblastic Leukemia. Blood, 84, 1603–1612.

    PubMed  CAS  Google Scholar 

  17. DeAngelo, D. J., Yu, D., Johnson, J. L., et al. (2007). Nelarabine induces complete remissions in adults with relapsed or refractory T-lineage acute lymphoblastic leukemia or lymphoblastic lymphoma: Cancer and Leukemia Group B study 19801. Blood, 109, 5136–5142.

    Article  PubMed  CAS  Google Scholar 

  18. Vitale, A., Guarini, A., Ariola, C., et al. (2007). Absence of prognostic impact of CD13 and/or CD33 antigen expression in adult acute lymphoblastic leukemia. Results of the GIMEMA ALL 0496 trial. Haematologica, 92, 342–348.

    Article  PubMed  CAS  Google Scholar 

  19. Thomas, D. A., O’Brien, S., Jorgensen, J. L., et al. (2009). Prognostic significance of CD20 expression in adults with de novo precursor B-lineage acute lymphoblastic leukemia. Blood, 113, 6330–6337.

    Article  PubMed  CAS  Google Scholar 

  20. Dworzak, M. N., Schumich, A., Printz, D., et al. (2008). CD20 up-regulation in pediatric B-cell precursor acute lymphoblastic leukemia during induction treatment: Setting the stage for anti-CD20 directed immunotherapy. Blood, 112, 3982–3988.

    Article  PubMed  CAS  Google Scholar 

  21. Lazarus, H. M., Richards, S. M., Chopra, R., et al. (2006). Central nervous system involvement in adult acute lymphoblastic leukemia at diagnosis: Results from the international ALL trial MRC UKALL XII/ECOG E2993. Blood, 108, 465–472.

    Article  PubMed  CAS  Google Scholar 

  22. Wetzler, M., Dodge, R. K., Mrozek, K., et al. (1999). Prospective karyotype analysis in adult acute lymphoblastic leukemia: The cancer and leukemia Group B experience. Blood, 93, 3983–3993.

    PubMed  CAS  Google Scholar 

  23. Pullarkat, V., Slovak, M. L., Kopecky, K. J., Forman, S. J., & Appelbaum, F. R. (2008). Impact of cytogenetics on the outcome of adult acute lymphoblastic leukemia: Results of Southwest Oncology Group 9400 study. Blood, 111, 2563–2572.

    Article  PubMed  CAS  Google Scholar 

  24. Mancini, M., Scappaticci, D., Cimino, G., et al. (2005). A comprehensive genetic classification of adult acute lymphoblastic leukemia (ALL): Analysis of the GIMEMA 0496 protocol. Blood, 105, 3434–3441.

    Article  PubMed  CAS  Google Scholar 

  25. Laughton, S. J., Ashton, L. J., Kwan, E., Norris, M. D., Haber, M., & Marshall, G. M. (2005). Early responses to chemotherapy of normal and malignant hematologic cells are prognostic in children with acute lymphoblastic leukemia. Journal of Clinical Oncology, 23, 2264–2271.

    Article  PubMed  CAS  Google Scholar 

  26. van der Velden, V. H., Cazzaniga, G., Schrauder, A., et al. (2007). Analysis of minimal residual disease by Ig/TCR gene rearrangements: Guidelines for interpretation of real-time quantitative PCR data. Leukemia, 21, 604–611.

    PubMed  Google Scholar 

  27. Bruggemann, M., Raff, T., Flohr, T., et al. (2006). Clinical significance of minimal residual disease quantification in adult patients with standard-risk acute lymphoblastic leukemia. Blood, 107, 1116–1123.

    Article  PubMed  Google Scholar 

  28. Mortuza, F. Y., Papaioannou, M., Moreira, I. M., et al. (2002). Minimal residual disease tests provide an independent predictor of clinical outcome in adult acute lymphoblastic leukemia. Journal of Clinical Oncology, 20, 1094–1104.

    Article  PubMed  Google Scholar 

  29. Holowiecki, J., Krawczyk-Kulis, M., Giebel, S., et al. (2008). Status of minimal residual disease after induction predicts outcome in both standard and high-risk Ph-negative adult acute lymphoblastic leukaemia. The Polish Adult Leukemia Group ALL 4-2002 MRD Study. British Journal of Haematology, 142, 227–237.

    Article  PubMed  Google Scholar 

  30. Raff, T., Gokbuget, N., Luschen, S., et al. (2007). Molecular relapse in adult standard-risk ALL patients detected by prospective MRD monitoring during and after maintenance treatment: Data from the GMALL 06/99 and 07/03 trials. Blood, 109, 910–915.

    Article  PubMed  CAS  Google Scholar 

  31. Cunningham, L., & Aplenc, R. (2007). Pharmacogenetics of acute lymphoblastic leukemia treatment response. Expert Opinion on Pharmacotherapy, 8, 2519–2531.

    Article  PubMed  CAS  Google Scholar 

  32. Relling, M. V., Hancock, M. L., Rivera, G. K., et al. (1999). Mercaptopurine therapy intolerance and heterozygosity at the thiopurine S-methyltransferase gene locus. Journal of the National Cancer Institute, 91, 2001–2008.

    Article  PubMed  CAS  Google Scholar 

  33. Relling, M. V., Hancock, M. L., Boyett, J. M., Pui, C. H., & Evans, W. E. (1999). Prognostic importance of 6-mercaptopurine dose intensity in acute lymphoblastic leukemia. Blood, 93, 2817–2823.

    PubMed  CAS  Google Scholar 

  34. Rocha, J. C., Cheng, C., Liu, W., et al. (2005). Pharmacogenetics of outcome in children with acute lymphoblastic leukemia. Blood, 105, 4752–4758.

    Article  PubMed  CAS  Google Scholar 

  35. Mullighan, C. G., Goorha, S., Radtke, I., et al. (2007). Genome-wide analysis of genetic alterations in acute lymphoblastic leukaemia. Nature, 446, 758–764.

    Article  PubMed  CAS  Google Scholar 

  36. Mullighan, C. G., Flotho, C., & Downing, J. R. (2005). Genomic assessment of pediatric acute leukemia. Cancer Journal, 11, 268–282.

    Article  CAS  Google Scholar 

  37. Mullighan, C. G., & Downing, J. R. (2009). Global genomic characterization of acute lymphoblastic leukemia. Seminars in Hematology, 46, 3–15.

    Article  PubMed  CAS  Google Scholar 

  38. Mullighan, C. G., Su, X., Zhang, J., et al. (2009). Deletion of IKZF1 and prognosis in acute lymphoblastic leukemia. The New England Journal of Medicine, 360, 470–480.

    Article  PubMed  CAS  Google Scholar 

  39. Fielding, A. K., Richards, S. M., Chopra, R., et al. (2007). Outcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL); an MRC UKALL12/ECOG 2993 study. Blood, 109, 944–950.

    Article  PubMed  CAS  Google Scholar 

  40. Tavernier, E., Boiron, J. M., Huguet, F., et al. (2007). Outcome of treatment after first relapse in adults with acute lymphoblastic leukemia initially treated by the LALA-94 trial. Leukemia, 21, 1907–1914.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. University College London Medical School, London, UK

    Adele K. Fielding

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  1. Adele K. Fielding
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Editors and Affiliations

  1. Cleveland Clinic Foundation, Euclid Ave. 9500, Cleveland, 44195, Ohio, USA

    Anjali S. Advani

  2. School of Medicine, University Hospitals of Cleveland, Euclid Avenue 11100, Cleveland, 44106, Ohio, USA

    Hillard M. Lazarus

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Fielding, A.K. (2011). Prognostic Factors in Adult Acute Lymphoblastic Leukemia (ALL). In: Advani, A., Lazarus, H. (eds) Adult Acute Lymphocytic Leukemia. Contemporary Hematology. Humana Press. https://doi.org/10.1007/978-1-60761-707-5_7

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  • DOI: https://doi.org/10.1007/978-1-60761-707-5_7

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-706-8

  • Online ISBN: 978-1-60761-707-5

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