Pediatric-based protocol improves outcomes in elderly patients with ALL

Results from a Norwegian prospective population-based study evaluating a pediatric-based regimen in 52 newly diagnosed patients above 65 years of age (median age, 70 years; range, 65–82) with acute lymphoblastic leukemia (ALL) were recently published in the British Journal of Haematology by Quist-Paulsen et al. Patients who were Philadelphia chromosome (Ph)-negative (n = 32) received unmodified doses of pegylated asparaginase starting on Day 30, while Ph-positive patients (n = 20) were treated with imatinib. 

Key data: The 2-year and 5-year overall survival rates were 0.60 (95% confidence interval [CI], 0.46–0.74) and 0.50 (95% CI, 0.34–0.66) respectively, with a median follow-up of 3.2 years. Treatment-related mortality was approximately 10%, with four deaths from septic shock during remission. Ten patients (19%) experienced a relapse. 

Key learning: This study demonstrated that a pediatric-based protocol is feasible and effective in elderly patients with ALL, achieving 50% long-term survival and low relapse rates.