Allogeneic transplant compared to pediatric-inspired therapy for Philadelphia chromosome-negative adolescent and adult ALL in first complete remission

• DOI: 10.1038/s41409-022-01595-9
• Publication Date: 2022-02-02T13:02:56Z
• Authors: Alfadil Haroon; Feras Alfraih; Amr Hanbali; Ahmed Kotb; Zakiah Al Somali; Fahad N. Bahkali; Saud Alhayli; Heba Mahmoud Madien; Syed Osman Ahmed; Abdulwahab A. Alb...; Marwan Shaheen; Naeem Chaudhri; Fahad Alsharif; Alfadel Alshaibani; Ahmad S. Alotaibi; Tusneem Elhassan; Fahad Almohareb; Ali Alahmari; Walid Rasheed; Hazzaa Alzahrani; Mahmoud Aljurf; Riad El Fakih
• Keywords: Pediatric cancer

Pediatric-inspired non-transplant regimens for adolescent and adult ALL patients are becoming standard in many institutions. We aimed to compare a cohort of patients receiving a pediatric-inspired protocol to a cohort of patients treated with adult type ALL therapy followed by allografting after achieving CR1.Eighty-five adolescent and adult ALL patients treated with CALGB 19802 protocol who received MSD transplant in CR1 were retrospectively compared to a matched cohort of 72 adolescent and adult ALL patients treated with a modified version of Children's Cancer Group (CCG) 1900 protocol.The five years OS in the allo-HCT cohort was 63.1% compared to 80.2% in the pediatric-inspired chemotherapy arm (P = 0.03). The five years EFS in the allo-HCT arm was 58.8% compared to 61.6% in the pediatric-inspired chemotherapy arm (P = 0.07). The five years DFS in the allo-HCT arm was 58.8% as compared to 71.9% in the pediatric-inspired chemotherapy arm (P = 0.07). The relapse rate in the allo-HCT cohort was 30.58% compared to 21.68% in the pediatric-inspired chemotherapy arm (P = 0.16). The NRM in the allo-HCT cohort was 10.59 as compared to 6.45 in the pediatric-inspired chemotherapy arm (P = 0.3).For adolescent and adult patients with Ph-negative ALL, pediatric-inspired chemotherapy resulted in higher OS compared to allo-HCT.