Results of the treatment of adult acute lymphoblastic leukemia according to ALL-2005 protocol as a basis for new trials

Elena Nikolaevna Parovichnikova; Паровичникова Елена Николаевна; Yuliya Rubenovna Davidyan; Давидян Юлия Рубеновна; Valentin Grigor'evich Isaev; Исаев Валентин Григорьевич; Andrey Nikolaevich Sokolov; Соколов Андрей Николаевич; Galina Aleksandrovna Klyasova; Клясова Галина Александровна; Larisa Pavlovna Mendeleeva; Менделеева Лариса Павловна; Lidiya Semenovna Lyubimova; Любимова Лидия Семеновна; Elena Nikolaevna Ustinova; Устинова Елена Николаевна; Elena Olegovna Gribanova; Грибанова Елена Олеговна; Elena Sergeevna Mavrina; Маврина Елена Сергеевна; Sergey Mikhaylovich Kulikov; Куликов Сергей Михайлович; Kamil' Daniyalovich Kaplanov; Капланов Камиль Даниялович; Tamara Pavlovna Zagoskina; Загоскина Тамара Павловна; Ekaterina Il'inichna Sviridova; Свиридова Екатерина Ильинична; Lyubov' Vladimirovna Gavrilova; Гаврилова Любовь Владимировна; Valeriy Grigor'evich Savchenko; Савченко Валерий Григорьевич; E N Parovichnikova; Parovichnikova E N; Yu R Davidyan; Davidyan Yu R; V G Isaev; Isaev V G; A N Sokolov; Sokolov A N; G A Klyasova; Klyasova G A; L P Mendeleeva; Mendeleeva L P; L S Lyubimova; Lyubimova L S; E N Ustinova; Ustinova E N; E O Gribanova; Gribanova E O; E S Mavrina; Mavrina E S; S M Kulikov; Kulikov S M; K D Kaplanov; Kaplanov K D; T P Zagoskina; Zagoskina T P; E I Sviridova; Sviridova E I; L V Gavrilova; Gavrilova L V; V G Savchenko; Savchenko V G

Results of the treatment of adult acute lymphoblastic leukemia according to ALL-2005 protocol as a basis for new trials

Authors: Parovichnikova E.N.¹, Davidyan Y.R.¹, Isaev V.G.¹, Sokolov A.N.¹, Klyasova G.A.¹, Mendeleeva L.P.¹, Lyubimova L.S.¹, Ustinova E.N.¹, Gribanova E.O.¹, Mavrina E.S.¹, Kulikov S.M.¹, Kaplanov K.D.², Zagoskina T.P.³, Sviridova E.I.⁴, Gavrilova L.V.⁵, Savchenko V.G.¹, Parovichnikova EN¹, Davidyan Y.R¹, Isaev VG¹, Sokolov AN¹, Klyasova GA¹, Mendeleeva LP¹, Lyubimova LS¹, Ustinova EN¹, Gribanova EO¹, Mavrina ES¹, Kulikov SM¹, Kaplanov KD¹, Zagoskina TP¹, Sviridova EI¹, Gavrilova LV¹, Savchenko VG¹
Affiliations:
1. ГУ Гематологический научный центр РАМН
2. Волгоградский областной онкологический диспансер
3. Кировский НИИ гематологии и переливания крови
4. Тамбовская областная клиническая больница
5. Саранская городская клиническая больница № 4
Issue: Vol 81, No 7 (2009)
Pages: 8-15
Section: Editorial
URL: https://journals.rcsi.science/0040-3660/article/view/30343
ID: 30343

Cite item

Abstract

Aim. To analyse the results of the treatment according to ALL-2005 protocol for adult patients with acute lymphoblastic leukemia (ALL); on the basis of the summarized evidence on ALL treatment to propose principles for development of a new program of ALL treatment in 15-55-year-old patients.
Material and methods. Five hematological centers (in Moscow, Saransk, Volgograd, Tambov, Kirov) participated in ALL-2005 protocol trial initiated in 2005. A total of 71 adult patients with ALL (age median 27 years) were treated. The results of the MB-2002 study with participation of 16 patients aged 16-23 years performed in the State Hematological Research Center (SHRC) were reviewed.
Results. The results of the induction therapy according to ALL-2005 protocol conducted in Moscow SHRC were good: a complete remission was achieved in 90% patients, early lethality was 6%, resistance was observed in 4%. In regional centers lethality in remission was higher, 5-year overall survival was 28% (in SHRC it was 56%), recurrence-free survival in regional center was 22% versus 51%, respectively. Long-term response by ALL-2005 and MB-2002 in patients aged 19-23 was the same, but toxicity of ALL-2005 treatment was higher (no lethality and 5, 4% in induction and remission, respectively).
Conclusion. The decision was made on design of a new protocol of treatment of Ph-negative ALL for patients aged from 15 to 55 years the main principles of which are the following: continuous treatment with modification of cytostatic drugs doses depending on myelosuppression severity; assessment of tumor cells sensitivity to prednisolone and its replacement for dexametasone throughout the treatment; prolongation of L-asparaginase treatment with elevation of its total dose; monitoring of minimal residual disease (MRD) for decision on late intensification in patients with MRD at late treatment stages (5 months).

Keywords

acute lymphoblastic leukemia, therapy, ALL-2005 protocol, MB-2002 protocol, minimal residual disease, prednisolone, dexametasone, L-asparaginase

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Results of the treatment of adult acute lymphoblastic leukemia according to ALL-2005 protocol as a basis for new trials

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