Survival in adults under 66 years with acute lymphocytic leukemia diagnosed in Norway 2000–2007
Jon-Magnus Tangen1, Jorg Axel Bohl2, Yngvar Floisand3, Einar Haukaas4, Inger Anne Naess5, Tove Skjelbakken6
1Department of hematology, Ulleval University Hospital, Oslo, Norway; 2Hematology section, Haukeland University Hospital, Bergen, Norway; 3Hematology section, Rikshospitalet, Oslo, Norway; 4Department of onco-hematology, Stavanger University Hospital, Stavanger, Norway; 5Hematology section, St.Olav University Hospital, Trondheim, Norway; 6Hematology section, University Hospital of North Norway, Tromso, Norway
Summary
In the period 1.1.2000–31.12.2007 129 patients with ALL under 66 years who received treatment with curative intent were registered in Norway (B-ALL 103 T-ALL 26). The median age was 38,6 years (15,6–65,9 years). The majority (110 patients) were treated with a common national protocol consisting of prednisone, vincristine, asparginase, doxorubicin and cyclophosphamide as induction. Consolidation was daunorubicin, cytarabine and thioguanine, followed by methotrexate i.v. and mercaptopurine per os. Maintenance was prednisone, vincristine and doxorubicin i.v. followed by methotrexate and mercaptopurine per os, given as part of a 3 months cycle repeatedly for 3 ½ years. CNS prophylaxis consisted of i.t. injections of methotrexate. Patients with high risk ALL were elegible for allogenous stem cell transplantation in CR 1.
In all 82,9% reached CR. For patients < 40 years and for patients ≥ 40 years CR rates were 91,4% and 72,9%, respectively. Nine patients received SCT in CR 1 and 2 patients received SCT in CR 2. Five year overall survival was 48,6% (SD 43,0%–54,2%), for patients < 40 years 54,9% (SD 47,3%–62,5%) and for patients ≥40 years 34,9% (SD 26,1%–43,7%).
Keywords
acute lymphatic leukemia, chemotherapy, stem cell transplantation, remission frequency, overall survival
