Leucemia linfoblástica aguda estirpe B Philadelphia negativa en adolescentes y adultos jóvenes: Resultados del Protocolo Terapéutico LLA 15-30, Programa Nacional de Cáncer del Adulto (PANDA), Ministerio de Salud, Chile

• Bárbara Puga ; Carolina Guerra ; Javiera Molina ^[1] ; María Elena Cabrera ^[1] ; Lilian Pilleux ^[3] ; Susana Calderón ^[3] ; Christine Rojas ^[4] ; Carmen Gloria Vergara ^[2] ; Hernán Rojas ^[5] ; Lina Muñoz ^[6] ; Vivianne Lois ^[6] ; Augusto Aspillaga ^[7] ; Álvaro Pizarro ^[8]
  1. [1] Hospital del Salvador

     Hospital del Salvador

     Santiago, Chile

     
  2. [2] Hospital San Juan de Dios

     Hospital San Juan de Dios

     Santiago, Chile

     
  3. [3] Hospital Valdivia
  4. [4] Hospital Gustavo Fricke
  5. [5] Hospital Sótero del Río
  6. [6] Hospital Barros Luco Trudeau
  7. [7] Hospital de Talca
  8. [8] Hospital San Borja Arriarán

  Mostrar afiliaciones +
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 142, Nº. 6, 2014, págs. 707-715
• Idioma: español
• Títulos paralelos:
  • Adolescent and young adult Philadelphia negative B cell acute lymphoblastic leukemia: Results of the Chilean protocol LLA 15-30
• Enlaces
  • Texto completo
• Resumen

  • Background: Intensified treatment of Philadelphia chromosome negative acute lymphoblastic leukemia (Ph(-)ALL) in adolescents by pediatric teams, with fve years disease free survival (DFS) rate of 65%, encouraged the use of intensified protocols in patients between 15 and 30 years, improving the DFS from 45% to 60-80%. The protocol LLA 15-30 for patients between 15 and 30 years with Ph(-)ALL, based on the Children’s Oncology Group (COG) protocol AALL0232 resulting in a five years DFS of 78%, was started in 2007 by the PANDA national program. Aim: To report the results of the prospective cohort study evaluating the results of this protocol four years after its implementation. Patients and Methods: Between January 2007 and December 2010, 68 Ph(-) ALL patients, aged between 15-30 years (75% males) were incorporated. Survival was evaluated using Kaplan-Meier and log-rank tests. Results: Fifty percent of patients were of high risk. A complete response was achieved in 91%, early death occurred in 6% and induction failure in 3%. Median follow-up was 23 months. Overall survival, disease free survival and relapse rates at 35 months were 61.8, 67.5% and 31% respectively. Conclusions: LLA 15-30 protocol significantly improved three-year overall survival from 31 to 62%. The 20% difference observed with AALL0232 protocol is explained by the high rate of relapse. Improving provider and patient compliance with protocols may eliminate this gap.