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Review
. 2018 Oct;93(10):1254-1266.
doi: 10.1002/ajh.25229. Epub 2018 Sep 3.

Treatment of young adults with Philadelphia-negative acute lymphoblastic leukemia and lymphoblastic lymphoma: Hyper-CVAD vs. pediatric-inspired regimens

Stuart E Siegel  1 , Anjali Advani  2 , Nita Seibel  3 , Lori Muffly  4 , Wendy Stock  5 , Selina Luger  6 , Bijal Shah  7 , Daniel J DeAngelo  8 , David R Freyer  9 , Dan Douer  10 , Rebecca H Johnson  11 , Brandon Hayes-Lattin  12 , Mark Lewis  13 , Jerry J Jaboin  14 , Peter F Coccia  15 , Archie Bleyer  16
Affiliations
Review

Treatment of young adults with Philadelphia-negative acute lymphoblastic leukemia and lymphoblastic lymphoma: Hyper-CVAD vs. pediatric-inspired regimens

Stuart E Siegel et al. Am J Hematol. 2018 Oct.

Abstract

For young adults with acute lymphoblastic leukemia, pediatric-based regimens are likely to provide the following when compared to hyper-CVAD regimens: better disease control, less hospitalization time, diminished acute toxicities, decreased financial cost, more quality-adjusted life years, and fewer adverse late effects, such as infertility, myelodysplasia, and second malignant neoplasms. There are also reasons to expect less cardiac and cognitive dysfunction after pediatric regimens. The improved quality and quantity of life associated with pediatric regimens renders them preferable to hyper-CVAD regimens for the treatment of Philadelphia-negative B-precursor or T-cell acute lymphoblastic leukemia and lymphoblastic lymphoma in young adults.

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Figures

FIGURE 1
FIGURE 1
Annual 5-year overall survival of children and AYAs <30 years of age, diagnosed with ALL (ICD-O-3 9801, 9826, 9827, 9831, 9835–9837) during 1975–2009, SEER9|13|18, by age. A, Individual data points and Joinpoint regressions. B, Joinpoint regressions and APC (APC, average annual percent change)/P values
FIGURE 2
FIGURE 2
Phases of therapy on hyper-CVAD (upper panel) and the pediatric C10403 (lower panel) regimens during the first 8 months (A) and subsequent therapy (B)
See this image and copyright information in PMC

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