Advertisement
Journal of Clinical Oncology  
Search for:
Limit by:
  Browse by Subject or Issue
Home Search or Browse JCO My JCO Subscriptions Customer Service Site Map

Originally published as JCO Early Release 10.1200/JCO.2004.10.050 on September 7 2004

Journal of Clinical Oncology, Vol 22, No 20 (October 15), 2004: pp. 4075-4086
© 2004 American Society of Clinical Oncology.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Save to my personal folders
Right arrow Download to citation manager
Right arrowRights & Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Thomas, X.
Right arrow Articles by Fiere, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Thomas, X.
Right arrow Articles by Fiere, D.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Outcome of Treatment in Adults With Acute Lymphoblastic Leukemia: Analysis of the LALA-94 Trial

Xavier Thomas, Jean-Michel Boiron, Françoise Huguet, Hervé Dombret, Ken Bradstock, Norbert Vey, Tibor Kovacsovics, André Delannoy, Nathalie Fegueux, Pierre Fenaux, Aspasia Stamatoullas, Jean-Paul Vernant, Olivier Tournilhac, Agnès Buzyn, Oumedaly Reman, Christiane Charrin, Claude Boucheix, Jean Gabert, Véronique Lhéritier, Denis Fiere

From the Hôpital Edouard Herriot, Lyon; Hôpital du Haut Levêque, Pessac; Hôpital Purpan, Toulouse; Hôpital Saint-Louis; Hôpital Pitié-Salpétrière; Hôpital Necker, Paris; Institut Paoli Calmettes, Marseille; Centre Hospitalier Lapeyronie, Montpellier; Centre Hospitalier, Lille; Centre Henri Becquerel, Rouen; Hôtel-Dieu, Clermont-Ferrand; Centre Hospitalier, Caen; L’Institut National de la Santé et de la Recherche Médicale U268, Villejuif, France; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Hôpital de Jolimont, Haine St Paul, Belgium; and Westmead Hospital, Westmead, Australia

Address reprint requests to Xavier Thomas, MD, PhD, Service d’Hématologie, Hôpital Edouard Herriot, 69437, Lyon Cedex 03, France; e-mail: xavier.thomas{at}chu-lyon.fr

PURPOSE: We analyzed the benefits of a risk-adapted postremission strategy in adult lymphoblastic leukemia (ALL), and re-evaluated stem-cell transplantation (SCT) for high-risk ALL.

PATIENTS AND METHODS: A total of 922 adult patients entered onto the trial according to risk groups: standard-risk ALL (group 1), high-risk ALL (group 2), Philadelphia chromosome-positive ALL (group 3), and CNS-positive ALL (group 4). All received a standard four-drug/4-week induction course. Patients from group 1 who achieved a complete remission (CR) after one course of induction therapy were randomly assigned between intensive and less intensive postremission chemotherapy, whereas those who achieved CR after salvage therapy were then included in group 2. Patients in groups 2, 3, and 4 with an HLA-identical sibling were assigned to allogeneic SCT. In groups 3 and 4, autologous SCT was offered to all other patients, whereas in group 2 they were randomly assigned between chemotherapy and autologous SCT.

RESULTS: Overall, 771 patients achieved CR (84%). Median disease-free survival (DFS) was 17.5 months, with 3-year DFS at 37%. In group 1, the 3-year DFS rate was 41%, with no difference between arms of postremission randomization. In groups 2 and 4, the 3-year DFS rates were 38% and 44%, respectively. In group 2, autologous SCT and chemotherapy resulted in comparable median DFS. Patients with an HLA-matched sibling (groups 2 and 4) had improved DFS. Three-year DFS was 24% in group 3.

CONCLUSION: Allogeneic SCT improved DFS in high-risk ALL in the first CR. Autologous SCT did not confer a significant benefit over chemotherapy for high-risk ALL.

Supported in part by PHRC No. 94-95-97.02, Ministère de l’Emploi et de la Solidarité, France.

Authors’ disclosures of potential conflicts of interest are found at the end of this article.


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 haematolHome page
C. D. Baldus, J. Thibaut, N. Goekbuget, A. Stroux, C. Schlee, M. Mossner, T. Burmeister, S. Schwartz, C. D. Bloomfield, D. Hoelzer, et al.
Prognostic implications of NOTCH1 and FBXW7 mutations in adult acute T-lymphoblastic leukemia
Haematologica, October 1, 2009; 94(10): 1383 - 1390.
[Abstract] [Full Text] [PDF]

Home page
 haematolHome page
B. Patel, K. E. Kirkland, R. Szydlo, R. M. Pearce, R. E. Clark, C. Craddock, E. Liakopoulou, A. K. Fielding, S. Mackinnon, E. Olavarria, et al.
Favorable outcomes with alemtuzumab-conditioned unrelated donor stem cell transplantation in adults with high-risk Philadelphia chromosome-negative acute lymphoblastic leukemia in first complete remission
Haematologica, October 1, 2009; 94(10): 1399 - 1406.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
M. B. Tomblyn, M. Arora, K. S. Baker, B. R. Blazar, C. G. Brunstein, L. J. Burns, T. E. DeFor, K. E. Dusenbery, D. S. Kaufman, J. H. Kersey, et al.
Myeloablative Hematopoietic Cell Transplantation for Acute Lymphoblastic Leukemia: Analysis of Graft Sources and Long-Term Outcome
J. Clin. Oncol., August 1, 2009; 27(22): 3634 - 3641.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
R. Bassan, O. Spinelli, E. Oldani, T. Intermesoli, M. Tosi, B. Peruta, G. Rossi, E. Borlenghi, E. M. Pogliani, E. Terruzzi, et al.
Improved risk classification for risk-specific therapy based on the molecular study of minimal residual disease (MRD) in adult acute lymphoblastic leukemia (ALL)
Blood, April 30, 2009; 113(18): 4153 - 4162.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
V. Asnafi, A. Buzyn, S. Le Noir, F. Baleydier, A. Simon, K. Beldjord, O. Reman, F. Witz, T. Fagot, E. Tavernier, et al.
NOTCH1/FBXW7 mutation identifies a large subgroup with favorable outcome in adult T-cell acute lymphoblastic leukemia (T-ALL): a Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL) study
Blood, April 23, 2009; 113(17): 3918 - 3924.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
V. Bachanova, M. R. Verneris, T. DeFor, C. G. Brunstein, and D. J. Weisdorf
Prolonged survival in adults with acute lymphoblastic leukemia after reduced-intensity conditioning with cord blood or sibling donor transplantation
Blood, March 26, 2009; 113(13): 2902 - 2905.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
F. Huguet, T. Leguay, E. Raffoux, X. Thomas, K. Beldjord, E. Delabesse, P. Chevallier, A. Buzyn, A. Delannoy, Y. Chalandon, et al.
Pediatric-Inspired Therapy in Adults With Philadelphia Chromosome-Negative Acute Lymphoblastic Leukemia: The GRAALL-2003 Study
J. Clin. Oncol., February 20, 2009; 27(6): 911 - 918.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
J. J. Cornelissen, B. van der Holt, G. E. G. Verhoef, M. B. van 't Veer, M. H. J. van Oers, H. C. Schouten, G. Ossenkoppele, P. Sonneveld, J. Maertens, M. van Marwijk Kooy, et al.
Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison
Blood, February 5, 2009; 113(6): 1375 - 1382.
[Abstract] [Full Text] [PDF]

Home page
 Am Soc Clin Oncol Ed BookHome page
D. Hoelzer and N. Gokbuget
Allogeneic Stem Cell Transplant in Acute Lymphoblastic Leukemia: Who and When?
ASCO Educational Book, January 1, 2009; 2009(1): 355 - 359.
[Abstract] [Full Text] [PDF]

Home page
 Am Soc Clin Oncol Ed BookHome page
F. Huguet, N. Boissel, and H. Dombret
Acute Lymphoblastic Leukemia in Adolescents and Young Adults: Is the Treatment Paradigm Changing?
ASCO Educational Book, January 1, 2009; 2009(1): 360 - 364.
[Abstract] [Full Text] [PDF]

Home page
 haematolHome page
A. Usvasalo, R. Raty, S. Knuutila, K. Vettenranta, A. Harila-Saari, E. Jantunen, M. Kauppila, P. Koistinen, K. Parto, P. Riikonen, et al.
Acute lymphoblastic leukemia in adolescents and young adults in Finland
Haematologica, August 1, 2008; 93(8): 1161 - 1168.
[Abstract] [Full Text] [PDF]

Home page
 haematolHome page
L. Fouillard, M. Labopin, A. Gratwohl, E. Gluckman, F. Frassoni, D. W. Beelen, R. Willemze, E. Montserrat, D. Blaise, A. I. Atienza, et al.
Results of syngeneic hematopoietic stem cell transplantation for acute leukemia: risk factors for outcomes of adults transplanted in first complete remission
Haematologica, June 1, 2008; 93(6): 834 - 841.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
C. Roche-Lestienne, L. Deluche, S. Corm, I. Tigaud, S. Joha, N. Philippe, S. Geffroy, J.-L. Lai, F.-E. Nicolini, C. Preudhomme, et al.
RUNX1 DNA-binding mutations and RUNX1-PRDM16 cryptic fusions in BCR-ABL+ leukemias are frequently associated with secondary trisomy 21 and may contribute to clonal evolution and imatinib resistance
Blood, April 1, 2008; 111(7): 3735 - 3741.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
A. H. Goldstone, S. M. Richards, H. M. Lazarus, M. S. Tallman, G. Buck, A. K. Fielding, A. K. Burnett, R. Chopra, P. H. Wiernik, L. Foroni, et al.
In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993)
Blood, February 15, 2008; 111(4): 1827 - 1833.
[Abstract] [Full Text] [PDF]

Home page
 haematolHome page
M. Mohty, M. Labopin, R. Tabrizzi, N. Theorin, A. A Fauser, A. Rambaldi, J. Maertens, S. Slavin, I. Majolino, A. Nagler, et al.
Reduced intensity conditioning allogeneic stem cell transplantation for adult patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation
Haematologica, February 1, 2008; 93(2): 303 - 306.
[Abstract] [Full Text] [PDF]

Home page
 Am Soc Clin Oncol Ed BookHome page
F. R. Appelbaum
Indications for Hematopoietic Cell Transplantation for the Treatment of Adult Acute Leukemia
ASCO Educational Book, January 1, 2008; 2008(1): 325 - 329.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
O. Ottmann, H. Dombret, G. Martinelli, B. Simonsson, F. Guilhot, R. A. Larson, G. Rege-Cambrin, J. Radich, A. Hochhaus, A. M. Apanovitch, et al.
Dasatinib induces rapid hematologic and cytogenetic responses in adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia with resistance or intolerance to imatinib: interim results of a phase 2 study
Blood, October 1, 2007; 110(7): 2309 - 2315.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
J. M. Rowe and A. H. Goldstone
How I treat acute lymphocytic leukemia in adults
Blood, October 1, 2007; 110(7): 2268 - 2275.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
J. Bergeron, E. Clappier, I. Radford, A. Buzyn, C. Millien, G. Soler, P. Ballerini, X. Thomas, J. Soulier, H. Dombret, et al.
Prognostic and oncogenic relevance of TLX1/HOX11 expression level in T-ALLs
Blood, October 1, 2007; 110(7): 2324 - 2330.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
C. D. Baldus, P. Martus, T. Burmeister, S. Schwartz, N. Gokbuget, C. D. Bloomfield, D. Hoelzer, E. Thiel, and W. K. Hofmann
Low ERG and BAALC Expression Identifies a New Subgroup of Adult Acute T-Lymphoblastic Leukemia With a Highly Favorable Outcome
J. Clin. Oncol., August 20, 2007; 25(24): 3739 - 3745.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
A. V. Moorman, C. J. Harrison, G. A. N. Buck, S. M. Richards, L. M. Secker-Walker, M. Martineau, G. H. Vance, A. M. Cherry, R. R. Higgins, A. K. Fielding, et al.
Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial
Blood, April 15, 2007; 109(8): 3189 - 3197.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
A. de Labarthe, P. Rousselot, F. Huguet-Rigal, E. Delabesse, F. Witz, S. Maury, D. Rea, J.-M. Cayuela, M.-C. Vekemans, O. Reman, et al.
Imatinib combined with induction or consolidation chemotherapy in patients with de novo Philadelphia chromosome-positive acute lymphoblastic leukemia: results of the GRAAPH-2003 study
Blood, February 15, 2007; 109(4): 1408 - 1413.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
A. K. Fielding, S. M. Richards, R. Chopra, H. M. Lazarus, M. R. Litzow, G. Buck, I. J. Durrant, S. M. Luger, D. I. Marks, I. M. Franklin, et al.
Outcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL); an MRC UKALL12/ECOG 2993 study
Blood, February 1, 2007; 109(3): 944 - 950.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
J.-M. Ribera, J.-J. Ortega, A. Oriol, P. Bastida, C. Calvo, J.-M. Perez-Hurtado, M.-E. Gonzalez-Valentin, V. Martin-Reina, A. Molines, F. Ortega-Rivas, et al.
Comparison of Intensive Chemotherapy, Allogeneic, or Autologous Stem-Cell Transplantation As Postremission Treatment for Children With Very High Risk Acute Lymphoblastic Leukemia: PETHEMA ALL-93 Trial
J. Clin. Oncol., January 1, 2007; 25(1): 16 - 24.
[Abstract] [Full Text] [PDF]

Home page
 ASH Education BookHome page
H. M. Lazarus and S. Luger
Which Patients with Adult Acute Lymphoblastic Leukemia Should Undergo a Hematopoietic Stem Cell Transplantation? Case-Based Discussion
Hematology, January 1, 2007; 2007(1): 444 - 452.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
I. Yakoub-Agha, F. Mesnil, M. Kuentz, J. M. Boiron, N. Ifrah, N. Milpied, S. Chehata, H. Esperou, J.-P. Vernant, M. Michallet, et al.
Allogeneic Marrow Stem-Cell Transplantation From Human Leukocyte Antigen-Identical Siblings Versus Human Leukocyte Antigen-Allelic-Matched Unrelated Donors (10/10) in Patients With Standard-Risk Hematologic Malignancy: A Prospective Study From the French Society of Bone Marrow Transplantation and Cell Therapy
J. Clin. Oncol., December 20, 2006; 24(36): 5695 - 5702.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
C. D. Baldus, T. Burmeister, P. Martus, S. Schwartz, N. Gokbuget, C. D. Bloomfield, D. Hoelzer, E. Thiel, and W. K. Hofmann
High Expression of the ETS Transcription Factor ERG Predicts Adverse Outcome in Acute T-Lymphoblastic Leukemia in Adults
J. Clin. Oncol., October 10, 2006; 24(29): 4714 - 4720.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
H. M. Lazarus, S. M. Richards, R. Chopra, M. R. Litzow, A. K. Burnett, P. H. Wiernik, I. M. Franklin, M. S. Tallman, L. Cook, G. Buck, et al.
Central nervous system involvement in adult acute lymphoblastic leukemia at diagnosis: results from the international ALL trial MRC UKALL XII/ECOG E2993
Blood, July 15, 2006; 108(2): 465 - 472.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
C.-H. Pui and W. E. Evans
Treatment of Acute Lymphoblastic Leukemia
N. Engl. J. Med., January 12, 2006; 354(2): 166 - 178.
[Full Text] [PDF]

Home page
 ASH Education BookHome page
S. E. Sallan
Myths and Lessons from the Adult/Pediatric Interface in Acute Lymphoblastic Leukemia
Hematology, January 1, 2006; 2006(1): 128 - 132.
[Abstract] [Full Text] [PDF]

Home page
 ASH Education BookHome page
N. Gokbuget and D. Hoelzer
Treatment of Adult Acute Lymphoblastic Leukemia
Hematology, January 1, 2006; 2006(1): 133 - 141.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
J. M. Rowe, G. Buck, A. K. Burnett, R. Chopra, P. H. Wiernik, S. M. Richards, H. M. Lazarus, I. M. Franklin, M. R. Litzow, N. Ciobanu, et al.
Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993
Blood, December 1, 2005; 106(12): 3760 - 3767.
[Abstract] [Full Text] [PDF]

Home page
 Mayo Clin Proc.Home page
E. J. Jabbour, S. Faderl, and H. M. Kantarjian
Adult Acute Lymphoblastic Leukemia
Mayo Clin. Proc., November 1, 2005; 80(11): 1517 - 1527.
[Abstract] [PDF]

Home page
 BloodHome page
V. Asnafi, A. Buzyn, X. Thomas, F. Huguet, N. Vey, J.-M. Boiron, O. Reman, J.-M. Cayuela, V. Lheritier, J.-P. Vernant, et al.
Impact of TCR status and genotype on outcome in adult T-cell acute lymphoblastic leukemia: a LALA-94 study
Blood, April 15, 2005; 105(8): 3072 - 3078.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
T. Kober, J. Bohlius, S. Trelle, and A. Engert
Second Biannual Report of the Cochrane Haematological Malignancies Group
J Natl Cancer Inst, April 6, 2005; 97(7): E1 - E.
[Full Text]

Home page
 ASH Education BookHome page
D. J. DeAngelo
The Treatment of Adolescents and Young Adults with Acute Lymphoblastic Leukemia
Hematology, January 1, 2005; 2005(1): 123 - 130.
[Abstract] [Full Text] [PDF]


About
JCO		 Editorial
Roster		 Advertising
Information		 Librarians &
Institutions		 Rights &
Permissions		 PDA Services

Copyright © 2004 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
Terms and Conditions of Use
  HighWire Press HighWire Press™ assists in the publication of JCO Online