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Treatment outcome in adults with acute lymphoblastic leukemia: 50% long-term disease-free survival

Leukemia volume 21, pages 2203–2204 (2007)Cite this article

Actuarial long-term disease-free survival (DFS) for adults with acute lymphoblastic leukemia (ALL) less than 60 years of age is 29–39% in large multicentre studies.1, 2, 3, 4 We have previously reported favorable outcome for patients less than 60 years of age treated according to our institutional protocol: actuarial 8-year overall survival (OS) 47% and DFS 44%.5 Actual survival, however, is rarely reported in the medical literature. The purpose of this report is to present the actual 8-year survival for adults with ALL treated in our hospital.

Induction therapy included prednisone, vincristine, L-asparaginase, doxorubicin and cyclophosphamide. Consolidation was daunorubicin, cytarabine and 6-thioguanine, followed by two courses of high-dose methotrexate and 6-mercaptopurine orally for 7 weeks. Maintenance was prednisone, vincristine, doxorubicin and cyclophosphamide followed by methotrexate alternating with 6-mercaptopurine orally as part of 12-week re-induction cycles for 3 years. Central nervous system prophylaxis consisted of 10 intrathecal injections of methotrexate. The protocol has been described in detail elsewhere.5 High-dose methotrexate was increased from 500 to 1500 mg/m2 through 1000 mg/m2 following our previous report, but apart from this dose escalation the protocol has been unchanged during the study period. Patients in 2.complete remission (2.CR) with a suitable donor were allografted as part of salvage therapy. From the early 1990s, patients with high-risk ALL (t(9;22), 11q23 abnormalities, complex karyotype, pro-B or pro-T immunophenotype) were allografted in 1.complete remission (1.CR), if a suitable donor was available.

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Authors and Affiliations

  1. Medical Department, Division of Hematology, Rikshospitalet-Radiumhospitalet Medical Centre, University of Oslo, Oslo, Norway

    G E Tjønnfjord, T Gedde-Dahl III, D Heldal & L Brinch

  2. Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway

    G E Tjønnfjord

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  1. G E Tjønnfjord
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  2. T Gedde-Dahl III
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Correspondence to G E Tjønnfjord.

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Tjønnfjord, G., Gedde-Dahl, T., Heldal, D. et al. Treatment outcome in adults with acute lymphoblastic leukemia: 50% long-term disease-free survival. Leukemia 21, 2203–2204 (2007). https://doi.org/10.1038/sj.leu.2404751

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