Genova M.,Laboratory of Hematopathology and Immunology NSHATHD |
Angelova S.,Laboratory of Cytogenetics and Molecular Biology |
Balatsenko G.,Laboratory of Cytogenetics and Molecular Biology
Clinical and Transfusion Haematology | Year: 2013
Despite the huge progress in the therapy of acute lymphoblastic leukemia during the past two decades, this nosology remains a challenge. Our team set the aim of evaluating and comparing the results from the different first and second line therapeutic strategies in ALL, by evaluating overall survival and response rate. To achieve this goal, we performed an evaluation of all ALL patients, who received therapy in NSHATHD for the period between 01.2008 and 05.2013, who comprised a group of 65 patients with a median age of 41,67 years, the youngest patient being 18 years old and the oldest 65 years old, and with 66% very high risk and high risk patients in the group. The main protocols used as a first line therapy included GMALL 07/03, LALA 94, HyperCVAD, GALGB 8811, and the main second line regimens were GMALL 07/03 and HyperCVAD. The patients were stratified according their risk and age groups. We identified a CR rate of 67,8% for the first line therapy of the entire group and a 38% CR rate for the second line therapy. The five-year OS for the whole group was 23%, the median of the disease free survival was 9,93 months. No statistically significant difference could be established between the first line protocols, regarding OS. GMALL 07/03 and HyperCVAD demonstrated best results in terms of CR rate as a second line treatment with CR of 54.5% and 43.75% respectively. The OS amongst the eldest age group was 15.7%. In spite of the progress in the therapy of ALL, the limited results imply the growing significance of the allogeneic transplantation strategy for the ALL patients.