Outcomes of Adults Age 40 Years and Older With Newly Diagnosed ALL: A Multicenter Registry Analysis From the Hematology Cancer Consortium.
Outcomes in adults age 40 years and older with ALL are inferior to younger patients, with limited real-world data.
This is a retrospective analysis of adults age 40 years and older with newly diagnosed ALL enrolled in the Hematology Cancer Consortium registry from January 2019 to January 2021. Baseline variables, treatment patterns, response rates, toxicities, and survival were assessed. Overall survival (OS) and event-free survival (EFS) were estimated using Kaplan-Meier methodology.
Of 349 registered patients, 61.3% (n = 214/349) initiated therapy, while 38.6% (n = 135/349) refused therapy. B-ALL represented 81% of cases (n = 174/214). Berlin-Frankfurt-Münster was used in 61.6% (n = 132/214) and German ALL in 30.3% (n = 65/214). Induction mortality was 18.6% (n = 40/214), mainly infection-related. Complete remission rates were 59.8% among assessed patients (n = 128/214), with minimal residual disease negativity in 45.8% (n = 61/133). Treatment de-escalation due to intolerance occurred in 30.8% (n = 66/214), and 35% (n = 75/214) were lost to follow-up. 3.7% (n = 8) patients underwent allotransplantation. At a median follow-up of 34 months, 3-year OS and EFS rates for the entire cohort were 31% and 29.6%, respectively (n = 214). Median OS and EFS were 13 and 11 months, respectively.
Adults age 40 years and older with ALL in India have poor outcomes, driven by early mortality, treatment intolerance, and limited access to advanced therapies.
This is a retrospective analysis of adults age 40 years and older with newly diagnosed ALL enrolled in the Hematology Cancer Consortium registry from January 2019 to January 2021. Baseline variables, treatment patterns, response rates, toxicities, and survival were assessed. Overall survival (OS) and event-free survival (EFS) were estimated using Kaplan-Meier methodology.
Of 349 registered patients, 61.3% (n = 214/349) initiated therapy, while 38.6% (n = 135/349) refused therapy. B-ALL represented 81% of cases (n = 174/214). Berlin-Frankfurt-Münster was used in 61.6% (n = 132/214) and German ALL in 30.3% (n = 65/214). Induction mortality was 18.6% (n = 40/214), mainly infection-related. Complete remission rates were 59.8% among assessed patients (n = 128/214), with minimal residual disease negativity in 45.8% (n = 61/133). Treatment de-escalation due to intolerance occurred in 30.8% (n = 66/214), and 35% (n = 75/214) were lost to follow-up. 3.7% (n = 8) patients underwent allotransplantation. At a median follow-up of 34 months, 3-year OS and EFS rates for the entire cohort were 31% and 29.6%, respectively (n = 214). Median OS and EFS were 13 and 11 months, respectively.
Adults age 40 years and older with ALL in India have poor outcomes, driven by early mortality, treatment intolerance, and limited access to advanced therapies.
Authors
Jain Jain, Jain Jain, Sarma Sarma, Kulkarni Kulkarni, Karunakaran Karunakaran, Kayal Kayal, Ganesan Ganesan, Lk Lk, Damodar Damodar, Kapoor Kapoor, Palassery Palassery, Krishnan Krishnan, Roshan Roshan, Chozakade Chozakade, Asokan Asokan, Samuel Samuel, Karunamurthy Karunamurthy, Mathews Mathews, Sengar Sengar
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