The Results Of The Treatment Of Adolescents And Young Adults With Acute Lymphoblastic Leukaemia With The Paediatric Regimen

Purpose：The aim of the study was to test the therapeutic efficacy and securityof paediatric regimen in the treatment of adolescents and young adults with acutelymphoblastic leukaemia.Methods：A retrospective comparative analysis of efficacy and toxicity ofadolescents and young adults aged14to25years with Philadelphiachromosome-negative ALL,treated on either a paediatric regimen(n=35) between Jan2007and Sep2013or an adult regimen(n=46) between Aug2009and Sep2013wasundertaken.Results：The paediatric regimen had a71.4%complete remission(CR) rates ofone course,77.1%CR rates of two courses in contrast to the adult regimen,in whichCR rates of one course was76.1%(p=0.636)and CR rates of two courses was84.8%(p=0.381). There was no significant difference in induction mortality between thepaediatric regimen and adult regimen,14.3%vs.10.9%(p=0.903). The paediatricregimen had a39.2%disease-free survival(DFS) and41.7%overall survival(OS) at2years in contrast to the adult regimen,in which2-year DFS was26.3%(p=0.251)andOS was27.9%(p=0.391).There was no differences in the CR rate and the OS and theDFS between the paediatric regimen and adult regimen. However,the2-year DFS wassuperior for the paediatric regimen compared with the adult regimen for patients aged14to18years(41.2%vs12.5%, p=0.038).The5-year DFS and OS on the paediatricregimen were19.6%and22.2%,respectively. The presence of central nervous systemleukemia(CNSL) predicted for an adverse outcome. There was no differences in thetoxicity between the paediatric regimen and adult regimen(p>0.05). For the tworegimens,the most common toxicity during the induction phase was hematolocic toxicity,infections rate was65.7%and80.4%(p=0.134),respectively.5.7%and4.3%(p=1.000)patients died from infections,respectively.The intracranial hemorrhage ratewas5.7%and4.3%(p=1.000) during the induction phase,respectively.5.7%and4.3%(p=1.000) patients died from hemorrhage,respectively.The major toxicity duringintensification and maintenance phase of the two regimens was hematolocic toxicityalso,infections rate was75.0%and69.7%(p=0.660),respectively.8.3%and0.0%(p=0.173)patients died from infections,respectively.Conclusion：There was no significant differences in the CR rate and the OSand the DFS between the paediatric regimen and adult regimen in the treatment ofadolescents and young adults aged14to25years with Philadelphiachromosome-negative ALL. However,there was superior for the paediatric regimencompared with the adult regimen for patients aged14to18years.The toxicity ofpaediatric regimen was well tolerance.Future strategies should focus on preventingsome of the complications of the paediatric regimen to improve efficacy,particularlyinfections and hemorrhage.