Table 12.
Previous AYA ALL trials: age group 15 to 30 y
| Age group, y | No. | T-ALL/B-ALL, n (%) | Baseline TLC, ×109/L (%) | Cytogenetics (%) | CNS disease (%) | HSCT rate, % | Cranial RT | EFS, %; OS, % | Poor prognostic factors | |
|---|---|---|---|---|---|---|---|---|---|---|
| CCG 196148 | 16-21 | 262 | 47 (17)/174 (66)* | <50: 193 (73.6) ≥50: 69 (26.3) |
t(9;22): 10 (6.9) t(4;11): 2 (1.3) t(1;19): 9 (6.2) Hypodiploid: 1 (0.6) Hyperdiploidy: 10 (6.9)† |
CNS 1: 229 (87) CNS 2: 21 (8) CNS 3: 12 (4.5) |
4 | 18 Gy cranial radiation | 5 y: 72; 78 |
Baseline WBC count: > 50 × 109/L t(9;22) t(4;11) |
| DFCI 9101/950149 | 15-18 | 51 | 15 (9)/6 (70) | Median 6.5 (1.3-563) |
TEL-AML1 (PCR): 13 (25) |
CNS 2 or 3: 4(8) | Not recorded | Cranial irradiation was administered only to patients with high presenting WBC count, or CNS 3 disease or T-cell phenotype | 5 y: 78; 81 |
NR |
| Total therapy XV50 | 15-18 | 89 | 28 (31)/61 (69) | <10: 46 (51.6); 10-100: 29 (32.5); >100: 14 (15.7) |
t(9;22): 3 (3.3) t(4;11): 3 (3.3) t(1;19): 3 (3.3) t(12;21): 3 (3.3) |
CNS 1: 60 (67) CNS 2: 20 (22) CNS 3: 3 (3.3) Traumatic with blasts: 6 (6.7) |
11 | No cranial irradiation | 5 y: 86; 88 |
NR |
| FRALLE 200014 | 15-19 | 77 | 23 (29)/54 (70) | Median: 17.9 (1-458) | t(9;22): 1 (1.2) t(4;11): 2 (2.5) t(1;19): 5 (6.5) t(12;21): 3 (3.9) Normal: 24 (31) Hyperploid: 6 (7.7) Hypodiploidy: 2 (2.5) |
Not available | 12 | Cranial irradiation given | 5 y: 74; 80 |
NR |
| Modified DFCI 91-0169 | 18-60 | 85 | 24 (28)/61 (72) | Median: 10.5 High WBC count, >30 for pre-B and >100 for T ALL, 13 (15) |
Normal: 24 (28) MLL: 10 (12) t(1;19): 3 (4) Hyperdiploidy: 3 (4) Ph− patients only* |
CNS disease: 14 (16) |
NR | Cranial RT administered 1200 cGy/8 d | 3 y: 77; 83 |
Age >35 y Increased WBC count >30 × 109/L in B-ALL and >100 × 109/L in T-ALL MLL gene re-arrangement |
| PETHEMA ALL 9651 | 15-30 | 81 | 17 (20)/64 (79) | Mean WBC, 7.8 |
*t(9;22), t(4;11), t(1;19) were excluded |
NR | 0 | Not received cranial RT | 6 y: 61; 69 |
Slow response to induction therapy |
| FRALLE 2000BT52 | 15-29 | 89 | NR | NR | Ph− patients only* | CNS disease: 5 (5.6) |
28 | NR | 5 y: 61; 66 |
Age time to first delayed intensification |
| JALSG ALL 202 U53 | 16-24 | 139 | 31 (22)/107 (77) | Median: 10.5; <50-104 (75); ≥50-35 (25) |
Standard risk: 2 (1) Intermediate risk: 110 (79) High risk: 11(8) Very high risk:15 (11) Unknown: 1 (1)‡ Ph− patients only* |
CNS+ disease: 7 (5) |
15 | No cranial RT administered | 5 y: 67; 73 |
No significant prognostic factor identified |
| CCG 1882, 19017 | 16-20 | 197 | 16/65 | Median: 12.2 | t(9;22): 2 (3) t(4;11): 2 (3) |
NR | 3 (1.5) | CNS− patients: 1800 cGy/10 fractions CNS+ disease = 2400 cGy/12 fractions and 600 cGy/3 fractions |
7 y: 63; 67 |
Baseline WBC count, >50 × 109/L |
| DCOG ALL 6-910 | 15-18 | 47 | 26/72 | Median: 7.5 | t(9;22): 1 (2) t(1;19): 3 (7) |
3 (6) | 4 | NR | 5 y: 69; 79 |
NR |
NR, not recorded.
*
Forty-one not determined.
†
Karyotyping was done in only 144 patients.
‡
Cytogenetic subgroups: Very high-risk group: t(4;11), complex karyotype, low hypodiploidy/near triploidy; high-risk group: MLL translocations, monosomy 7 with <5 abnormalities, t(1;19); intermediate-risk group: normal karyotype, or other miscellaneous abnormal karyotypes; standard risk: high hyperdiploidy.