EurekaMag.com logo
+ Site Statistics
References:
53,869,633
Abstracts:
29,686,251
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Single centre experience with the Hyper-CVAD regimen in adult acute lymphoblastic leukemia Preliminary analysis of efficacy and toxicity



Single centre experience with the Hyper-CVAD regimen in adult acute lymphoblastic leukemia Preliminary analysis of efficacy and toxicity



Blood 98(11 Part 2): 216b, November 16



Hyper-CVAD represents an intensified program for the treatment of acute and chronic lymphoid malignancies. Although it has not been evaluated in a randomized fashion or compared with other ALL protocols it has been proposed as a highly efficient treatment for adult ALL, with acceptable toxicity profile (Kantarjian H.M. et al. JCO; 18:3, 2000). Purpose: In our institution, Hyper-CVAD was initiated in September 99 and used in the treatment of 14 consecutive adults with ALL. We analyze and report here our preliminary results focusing on the efficacy and the toxicity of the program. Patient and Methods: Patient population consisted of 10 de novo ALL (6 T-cell, 4 B-cell), group A, 2 blastic-phase CML (B-cell) and 2 relapsed ALL (B-cell), group B. M/F ratio was 10/4, median age 42.5 yrs, mean age 44 yrs (range 18-68 yrs). 6/14 (43%) patients were older than 50 yrs. Hyperleucocytosis of >100X109/L was present in 4/14 (28%) cases (3 T-cell, 1 B-cell) while splenomegaly, lymphadenopathy and bulky mediastinum were documented in 71%, 64% and 7% of cases respectively. Chromosome analysis was available in 12/14 patients, in 5 was normal, in 1 showed del(12), in 2 CML cases a typical t(9;22) and in 4 metaphases were insufficient. None of the cases presented with CNS disease (morphology+immunophenotyping) neither any non-CML case carried the bcr-abl translocation. Results: Median follow up was 6.5 months (range 18d-17mon). Hematological complete remission was achieved in 7/10 (70%) de novo ALL cases (group A) and in 1/4 (25%) relapsed ALL/blastic-CML cases (group B). Resistant disease was documented in 3/14 (21.4%) cases, which subsequently received other therapeutic protocols. Disease progression following initial response was seen in another 3 cases, 3 out of 5 (60%) evaluable T-ALL cases relapsed, 2 during the consolidation phase, 1 during maintenance. CNS involvement whilst on hyper-CVAD was not detected in the subgroup of resistant/progressive patients. Toxic deaths occurred in 3/14 (21.4%) cases, 2 of them in remission status. One death occurred in early induction and 2 in consolidation. Conclusions: Within the limitations of the small patient number and relatively short follow up we confirm the effectiveness of hyper-CVAD in de novo ALL, albeit at a lower than expected magnitude, in accordance with other reports (Lozada J.A. et al. Blood:96; 11 Abstr 4645). In contrast, results in secondary/relapsed ALL are poor. Furthermore, we are unable to confirm the reported excellent outcome in T-ALL. Toxicity, especially infectious complications, was significant despite the administration of growth factors and prophylactic antibiotics. The regimen can prevent leukemia extention to CNS in both responders and progressors. Different patient and ethnic characteristics may account for the disparate results presented in this study compared to the initial report.

(PDF emailed within 1 workday: $29.90)

Accession: 035734180

Download citation: RISBibTeXText



Related references

Treatment of Adult Acute Lymphoblastic Leukemia with the Hyper-CVAD Regimen Preliminary Analysis from a Single Center. Blood 100(11): Abstract No 4617, November 16, 2002

Effectiveness of modified hyper-CVAD chemotherapy regimen in the treatment of adult acute lymphoblastic leukemia: a retrospective experience. Cancer Medicine: -, 2018

Final results of a single institution experience with a pediatric-based regimen, the augmented Berlin-Frankfurt-M√ľnster, in adolescents and young adults with acute lymphoblastic leukemia, and comparison to the hyper-CVAD regimen. American Journal of Hematology 91(8): 819-823, 2017

Is the BFM Regimen Feasible for the Treatment of Adult Acute Lymphoblastic Leukemia? A Retrospective Analysis of the Outcomes of BFM and Hyper-CVAD Chemotherapy in Two Centers. ChemoTherapy 60(4): 219-223, 2015

Feasibility and outcome of the hyper-CVAD regimen in patients with adult acute lymphoblastic leukemia. Clinical Lymphoma, Myeloma & Leukemia 15(1): 52-57, 2015

Hyper-CVAD Compared With BFM-like Chemotherapy for the Treatment of Adult Acute Lymphoblastic Leukemia. A Retrospective Single-Center Analysis. Clinical Lymphoma, Myeloma & Leukemia 17(3): 179-185, 2016

Hyper-CVAD regimen in routine management of adult acute lymphoblastic leukemia: a retrospective multicenter study. Acta Haematologica 130(3): 199-205, 2013

Clinical characteristics and treatment outcome of adult acute lymphoblastic leukemia with t(4;11)(q21;q23) using a modified hyper-CVAD regimen. Acta Haematologica 122(1): 23-26, 2009

Efficacy of low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (CAG regimen) compared to Hyper-CVAD regimen as salvage chemotherapy in relapsed/refractory Philadelphia chromosome-negative acute lymphoblastic leukemia. Leukemia Research 39(3): 323-328, 2015

Comparison between Hyper-CVAD and PETHEMA ALL-93 in Adult Acute Lymphoblastic Leukemia: A Single-Center Study. ChemoTherapy 63(4): 207-213, 2018

Hyper-CVAD plus ponatinib versus hyper-CVAD plus dasatinib as frontline therapy for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia: A propensity score analysis. Cancer 122(23): 3650-3656, 2016

The hyper-CVAD regimen improves outcome in relapsed acute lymphoblastic leukemia. Leukemia (Basingstoke) 11(12): 2039-2044, 1997

The hyper-CVAD regimen improves outcome in relapsed acute lymphoblastic leukemia. Leukemia 11(12): 2039-2044, 1998

The Dana Farber consortium protocol (DFCP) vs. classic Hyper-CVAD for treatment of acute lymphoblastic leukemia in patients <50 Y. Single institution experience. Leukemia Research 60: 58-62, 2017

Hyper-CVAD plus nelarabine in newly diagnosed adult T-cell acute lymphoblastic leukemia and T-lymphoblastic lymphoma. American Journal of Hematology 93(1): 91-99, 2017