Evidence map›Paper›PMID 41610329›Full record

SynthesisBlood advances2026

Pediatric-inspired regimens and HSCT for adolescents and young adults with acute lymphoblastic leukemia.

Yuliia Sereda, Htun Ja Mai, Ghid Kanaan, John W Melson, Teruhiko Terasawa, Matthew C Cheung, Wendy Stock, Julie A Wolfson, Ian J Saldanha, Ethan M Balk

Abstract readMeta-AnalysisReview
In one paragraph

Synthesis in Blood advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yuliia SeredaCenter for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI.ORCID 0000-0002-4017-4561
Htun Ja MaiCenter for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI.ORCID 0009-0004-1357-1088
Ghid KanaanCenter for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI.ORCID 0009-0003-4910-9656
John W MelsonDivision of Hematology, Oncology, and Palliative Care, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA.ORCID 0009-0008-7498-3827
Teruhiko TerasawaDepartment of Emergency and General Internal Medicine, Fujita Health University, Toyoake, Japan.ORCID 0000-0002-0975-391X
Matthew C CheungDivision of Hematology/Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.ORCID 0000-0003-3193-5872
Wendy StockComprehensive Cancer Center, The University of Chicago, Chicago, IL.ORCID 0000-0002-8349-9200
Julie A WolfsonDivision of Pediatric Hematology-Oncology, The University of Alabama at Birmingham, Birmingham, AL.ORCID 0000-0002-3711-2239
Ian J SaldanhaCenter for Clinical Trials and Evidence Synthesis, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.ORCID 0000-0002-2062-3382
Ethan M BalkCenter for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI.ORCID 0000-0002-4376-7290

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

abstractThe best frontline treatment for acute lymphoblastic leukemia (ALL) in adolescents and young adults (AYAs) is unclear. To support a clinical practice guideline, we systematically reviewed and meta-analyzed evidence on (1) asparaginase-based (pediatric) vs non-asparaginase-based (adult) regimens and (2) allogeneic hematopoietic stem cell transplantation (HSCT) vs no HSCT for AYAs (aged 15-39 years) with ALL in first complete remission. Data sources were PubMed, CINAHL, and PsycINFO from inception to 29 November 2023. Eligible studies compared regimens or the use of HSCT and reported survival, remission, toxicity, or quality of life in AYAs. We included 19 studies (14 comparative, 5 single-group; N = 3607) comparing regimens and 7 studies (N = 7492) comparing HSCT and no HSCT. Studies were mostly of poor quality, with sparse randomized controlled trials (RCTs), yielding low-certainty findings. Pediatric regimens were associated with higher 5-year overall survival (OS; relative risk [RR], 1.40; 95% confidence interval [CI], 1.18-1.65), event-free survival (RR, 1.80; 95% CI, 1.13-2.85), disease-free survival (DFS; RR, 1.55; 95% CI, 1.32-1.82), and lower treatment-related mortality (TRM; RR, 0.29; 95% CI, 0.09-0.90). HSCT was associated with lower 5-year OS (RR, 0.72; 95% CI, 0.61-0.84) and DFS (RR, 0.78; 95% CI, 0.68-0.90) and higher nonrelapse mortality (RR, 2.70; 95% CI, 1.18-6.18) and TRM (hazard ratio, 6.88; 95% CI, 3.02-15.70). Relapse risk varied by time point. In AYAs with Philadelphia chromosome-negative ALL, pediatric regimens may improve survival; toxicity-related evidence remains limited. HSCT may lead to inferior OS and DFS. With a dearth of RCTs, low-certainty evidence highlights the need for high-quality studies and subanalyses of AYAs.

Indexed as

Hematopoietic Stem Cell TransplantationPrecursor Cell Lymphoblastic Leukemia-LymphomaAdolescentAdultHumansYoung Adult

Identifiers

PMID41610329
PMCPMC13207624

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.