Table 4.
Outcome With Hyper-CVAD and Modified Hyper-CVAD Regimens in De Novo Philadelphia Chromosome–Negative Precursor B-Lineage Acute Lymphoblastic Leukemia by Therapy and CD20 Status
| Characteristic | Modified Hyper-CVAD ± Rituximab |
Hyper-CVAD Without Rituximab (n = 109) |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2: Without Intensification (n = 126) |
1: With Intensification (n = 47) | |||||||||||
| CD20 Negative |
CD20 Positive |
CD20 Negative |
CD20 Positive |
CD20 Negative |
CD20 Positive |
|||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | |
| No. | 53 | 73 | 23 | 24 | 56 | 53 | ||||||
| Response, overall | ||||||||||||
| CR | 50 | 94 | 67 | 92 | 22 | 96 | 24 | 100 | 55 | 98 | 50 | 94 |
| CRp | 1 | 2 | 1 | 1 | 1 | 4 | — | — | — | |||
| NR | 1 | 2 | 2 | 3 | — | — | 1 | — | ||||
| ED | 1 | 2 | 3 | 4 | — | — | — | 3 | 6 | |||
| Follow-up, months | ||||||||||||
| Median | 41 | 90 | 132 | |||||||||
| Range | 4-81+ | 24-106+ | 6-200+ | |||||||||
| Relapse rate | 10 | 19 | 20 | 28 | 12 | 52 | 11 | 46 | 31 | 56 | 30 | 60 |
| Time to relapse, months | ||||||||||||
| Median | 30 | 27 | 10 | 25 | 30 | 11 | ||||||
| Range | 4-72 | 2-75 | 2-47 | 7-38 | 5-140 | 2-124 | ||||||
| Deaths in CR | ||||||||||||
| Overall | 4 | 8 | 13 | 18 | 4 | 17 | 3 | 13 | 5 | 9 | 2 | 4 |
| No. age ≥ 60 years | 0 | 9 | 4 | 3 | 2 | 1 | ||||||
| % 3-year CRD | ||||||||||||
| Overall by therapy | 78 | 53 | 54 | |||||||||
| % 3-year CRD | ||||||||||||
| Overall | 84 | 73 | 50 | 54 | 68 | 37 | ||||||
| Age, years | ||||||||||||
| ≤ 30 | 84 | 75 | 62* | 40* | 75 | 26 | ||||||
| 31-59 | 89 | 75 | 45* | 67* | 62 | 48 | ||||||
| ≥60 | 71 | 65 | 0* | 45* | 50* | 50* | ||||||
| % 3-year OS | ||||||||||||
| Overall by therapy | 60 | 55 | 55 | |||||||||
| % 3-year OS | ||||||||||||
| Overall | 63 | 57 | 44 | 65 | 65 | 45 | ||||||
| Age, years | ||||||||||||
| ≤ 30 | 77 | 75 | 63* | 80* | 84 | 47 | ||||||
| 31-59 | 56 | 66 | 55* | 78* | 58 | 48 | ||||||
| ≥ 60 | 60* | 15 | 0* | 45* | 20* | 34* | ||||||
Abbreviations: Hyper-CVAD, fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone; Modified hyper-CVAD 1, anthracycline intensification with or without rituximab; Modified hyper-CVAD 2, no anthracycline intensification with or without rituximab; CR, complete remission; CRp, CR with incomplete platelet recovery; NR, no response; ED, death during induction; CRD, CR duration; OS, overall survival.
*
Ten or fewer patients in cohort.