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ACUTE LYMPHOBLASTIC LEUKEMIA

Asparaginase completion among adults including older patients with acute lymphoblastic leukemia treated with a modified DFCI protocol

Leukemia volume 38, pages 912–913 (2024)Cite this article

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We read with interest the recent report by Valtis et al. [1], in which the authors assessed the importance of acute lymphoblastic leukemia (ALL) treatment protocol completion, and in particular of the total asparaginase (ASP) received doses, on the survival of 1159 childhood and 332 Adolescent and Young Adult (AYA) patients with Philadelphia chromosome-negative (Ph-) ALL, who were treated on four sequential pediatric and adult DFCI consortium protocols.

The authors reported a significant discrepancy in treatment completion rates between AYA and childhood patients, with the AYA group exhibiting lower rates of treatment completion compared to their younger counterparts (60.8% vs. 89.7%, p < 0.001). This discordance was attributed mainly to the higher incidence of early treatment failure among AYA patients (14.5% vs 2.4%, p < 0.001). While withdrawal from treatment due to toxicity, social/personal reasons, or reasons of unknown origin was relatively uncommon overall, it was more commonly observed in AYA patients (9.3% vs 4.7%, p = 0.001). Importantly, it was observed that overall survival (OS) and cumulative incidence of relapse (CIR) correlated with ASP completion status (≤vs >26 weeks of ASP), underscoring the importance of ASP on ALL outcomes.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

References

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Author notes

  1. These authors contributed equally: Andre C. Schuh, Hassan Sibai.

Authors and Affiliations

  1. Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Maria Agustina Perusini, Vikas Gupta, Dawn Maze, Karen W. L. Yee, Aniket Bankar, Marta B. Davidson, Guillaume Richard-Carpentier, Steven M. Chan, Aaron D. Schimmer, Salman Alharbi, Josephine A. Lucero, Swe Mar Linn, Mark D. Minden, Andre C. Schuh & Hassan Sibai

  2. Department of Haematology, St Vincent’s University Hospital, Dublin, Ireland

    Claire Andrews

  3. Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Atenafu G. Eshetu

  4. University Health Network, Toronto, ON, Canada

    Jad Sibai

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  1. Maria Agustina Perusini
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  2. Claire Andrews
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Contributions

MAP, AC, AS, and HS contributed to the conceptualization and design. MAP, AS and HS contributed to data analysis, interpretation, and writing of the manuscript. EGA contributed to data analysis. MAP, JAL, JS, SAH, and SWL contributed to data collection. VG, MD, SA, YK, BA, DM, GRC, CS, ADS, MM, and HS contributed to essential data and manuscript revision. All authors approved the submitted and final version.

Corresponding author

Correspondence to Maria Agustina Perusini.

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Competing interests

This study has not been funded by any pharmaceutical companies. There were no direct COI specifically related to this research project. ADS has received research funding from Takeda Pharmaceuticals, BMS, and Medivir AB, and consulting fees/honorarium from Takeda, Novartis, Jazz, and Otsuka Pharmaceuticals. ADS is named on a patent application for the use of DNT cells to treat AML. ADS is a member of the Medical and Scientific Advisory Board of the Leukemia and Lymphoma Society of Canada.

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Perusini, M.A., Andrews, C., Eshetu, A.G. et al. Asparaginase completion among adults including older patients with acute lymphoblastic leukemia treated with a modified DFCI protocol. Leukemia 38, 912–913 (2024). https://doi.org/10.1038/s41375-024-02201-1

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