ArticleEcancermedicalscience2025
Treatment outcome in adolescent and young adult acute lymphoblastic leukaemia (ALL) on BFM-95 protocol: experience of a tertiary care Institute from North India.
Article in Ecancermedicalscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: BFM-95 protocol is among the common regimens used to treat adolescent and young adult (AYA) acute lymphoblastic leukaemia. Five-year survival in AYA patients with acute lymphoblastic leukaemia is inferior when compared to children. Objective: To study treatment outcomes in adolescent and young adult patients with acute lymphoblastic leukaemia on BFM 95 protocol. Material and Methods: We retrospectively analysed the available data of 75 patients diagnosed with acute lymphoblastic leukaemia in the AYA age group who received treatment as per BFM-95 protocol from 2016 to 2020 in the clinical hematology department in a tertiary health care centre. Results: Among 75 patients, 56 were male and 19 were female. High-risk patients were 15 (20%), 3 due to poor prednisolone response and 12 due to high-risk cytogenetics. Most of the patients were CNS-1 and three patients were of CNS-3. Eight (10.6%) patients did not complete induction treatment. The median duration of induction phase A was 40 days (range 35-45 days). The most common complication during induction phase A treatment was febrile neutropenia which was seen in 21 patients (28%), followed by transaminitis in 12 patients (21.1%). The median duration of follow-up was 2 years (range 8 months-5 years). Five (6%) patients' bone marrow were not in remission after induction-A. Relapse occurred in 23 patients (30.6%), with the highest incidence observed during the maintenance phase of treatment. Thirty-three (44%) patients completed maintenance and were still on follow-up. Twenty-three (30.7%) patients relapsed while six patients were lost to follow-up during maintenance. At a median follow-up of 2 years, disease-free survival was (44%). Conclusion: This study on AYA patients with acute lymphoblastic leukaemia/lymphoma using a pediatric protocol in a resource-limited setting observed suboptimal survival rates, which may be attributed to the retrospective design, significant data gaps and a small patient cohort with limited follow-up.
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