ArticleJournal of global oncology2018
Adult Acute Lymphoblastic Leukemia: Limitations of Intensification of Therapy in a Developing Country.
Article in Journal of global oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Review
- Treatment outcome in adolescent and young adult acute lymphoblastic leukaemia (ALL) on BFM-95 protocol: experience of a tertiary care Institute from North India.Ecancermedicalscience · 2025Article
- Adult Philadelphia-Positive Acute Lymphoblastic Leukemia: A Single-Institution Experience in Limited-Resource Setting.South Asian journal of cancer · 2024Article
- Article
- Minimal Residual Disease in the Management of B-Cell Acute Lymphoblastic Leukemia: A Systematic Review of Studies from Indian Settings.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2024Review
- One-Year Survival and Prognosticators of Adults With Acute Leukemia at the Uganda Cancer Institute.JCO global oncology · 2023Article
- Management of B-cell lineage acute lymphoblastic leukemia: expert opinion from an Indian panelFrontiers in oncology · 2023Review
- Clinical Characteristics and Outcomes of Acute Lymphoblastic Leukemia in Adolescents and Young Adults in Malawi.JCO global oncology · 2022Observational
- Systematic application of fluorescence in situ hybridization and immunophenotype profile for the identification of ZNF384 gene rearrangements in B cell acute lymphoblastic leukemia.International journal of laboratory hematology · 2021Article
- The Outcome of Acute Lymphoblastic Leukemia in 109 Adult Iraqi Patients.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2021Article
- Outcomes in adolescent and young adult acute lymphoblastic leukaemia: a report from the Indian Acute Leukaemia Research Database (INwARD) of the Hematology Cancer Consortium (HCC).British journal of haematology · 2021Article
- Outcomes and prognostic factors in adolescents and young adults with ALL treated with a modified BFM-90 protocol.Blood advances · 2021Article
- Mechanisms of Immunosuppressive Tumor Evasion: Focus on Acute Lymphoblastic Leukemia.Frontiers in immunology · 2021Review
- Article
- Prognostic value of MRD monitoring based onLeukemia & lymphoma · 2020Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
Purpose Limited data exist on intensifying chemotherapy regimens in the treatment of adult acute lymphoblastic leukemia (ALL) outside the setting of a clinical trial. Materials and Methods Retrospectively, data from 507 consecutive adults (age ≥ 15 years) with a diagnosis of ALL treated at our center were analyzed. Standard-risk (SR) patients were offered treatment with a modified German Multicenter ALL (GMALL) regimen, whereas high-risk (HR) patients were offered intensification of therapy with hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (HCVAD). Because of resource constraints, a proportion of HR patients opted to receive the same treatment regimen as used for SR patients. Results There were 344 SR patients (67.8%) and 163 HR patients (32.2%) at diagnosis. Among the HR patients, 53 (32.5%) opted to receive intensification with the HCVAD regimen. The SR cohort showed a superior 5-year event-free survival rate compared with the HR cohort (47.3% v 23.6%, respectively; P < .001). Within the HR subgroup, there was no statistically significant difference in overall survival or event-free survival between patients who received the modified GMALL regimen (n = 59) and patients who received HCVAD (n = 53). Conclusion Intensified therapy in the HR subset was associated with a significant increase in early treatment-related mortality and cost of treatment. A modified GMALL regimen was found to be cost-effective with clinical outcomes comparable to those achieved with more intensive regimens.
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