Campus ALL study: Real-life management of older adults with Ph− ALL

Results from the retrospective Campus ALL study, evaluating the real-life management of 476 older adults with Philadelphia chromosome-negative (Ph−) acute lymphoblastic leukemia (ALL) across 42 centers in Italy, were recently published in Haematologica by Cerrano et al. Patients were aged ≥55 years, diagnosed between January 2013 and December 2023, and treated outside of clinical trials; the study aimed to obtain an understanding of the treatments and outcomes of patients in this real-life cohort.

Key data: The complete response / complete response with incomplete hematologic recovery (CR/CRi) rate after induction was 76%, with 30-day and 60-day mortality rates of 4% and 9%, respectively. Measurable residual disease (MRD) negativity was achieved in 35% of patients with CR/CRi and was associated with a lower risk of relapse (37% vs 55%; p = 0.008), reduced cumulative incidence of relapse (CIR; 38% vs 58% at 3 years; p = 0.001), and improved median relapse-free survival (RFS; 40.6 months vs 14 months; p = 0.001). Median overall survival (OS) was 21.3 months, with 3-year and projected 5-year OS rates of 40% and 31%, respectively. Pediatric-inspired regimens were associated with improved outcomes (hazard ratio [HR], 0.63; p = 0.009), while older age, very high-risk disease, and central nervous system (CNS) positivity were significant predictors of worse survival.

Key learning: This large, multicenter, retrospective study presented real-world data on the management of Ph− ALL in older patients treated outside of clinical trials in Italy. In older patients with Ph− ALL, pediatric-inspired regimens demonstrated superior outcomes and MRD status remained a strong prognostic factor.