The primary treatment of acute lymphocytic leukemia (ALL) has been considerably improved. In the first German multicenter study, 01/81 complete remissions have been induced in 272 of 368 patients (73.9%), and in the second study 02/84 in 350 of 442 (79.2%) [1]. Though 35% of the patients remain disease free after 7.5 years in the first study and 48% after 3 years in the second, relapsing and refractory disease is still the most prevalent problem in ALL. The development of effective salvage therapies is warranted. Against this background the German Multicenter ALL Study Group has evaluated an intensive protocol for patients with relapsed or refractory ALL.

Treatment of Relapsed or Refractory Adult Acute Lymphocytic Leukemia

Several recent reports have described the incidence and clinicopathologic features of childhood and adult T-lineage acute lymphoblastic leukemia (ALL) [1–7]. According to these reports, T-cell ALL accounts for approximately 15% of childhood and slightly over 20% of adult cases of ALL. It occurs more frequently in male adolescents or young adults and is usually associated with a mediastinal mass and high white blood cell count. In contrast to findings in children, in whom T-lineage ALL is usually associated with clinical risk factors and thus has a significantly worse treatment outcome than common ALL [2, 3,7], recent studies in adult patients with T-cell ALL have shown a remarkable improvement in the prognosis for this subgroups (reviewed in [8]).

Clinical importance of T-ALL subclassification according to thymic or prethymic maturation stage.

The purpose of evaluating prognostic factors in acute lymphoblastic leukemia is, first, to stratify patients into adverse- or good-risk groups, second, to determine different treatment options accordingly and, third, to evaluate their potential outcome. Prognostic factors are particularly relevant for disease-free survival and overall survival.

Change in prognostic factors

The treatment of acute lymphoblastic leukemia (ALL) with modern multidrug schedules is highly effective. In the first German multicenter study, 01/81, complete remissions were induced in 272 of 368 patients (73.9%), and in the second trial, 02/84, in 350 of 442 (79.2%) [1]. Though 35% of the patients remain disease free after 7.5 years in the first study and 48% after 3 years in the second, relapses are still frequent.

Treatment of relapsed acute lymphocytic leukemia in adults.

http://www.scielo.org.co/pdf/rcc/v20n4/v20n4a03.pdf

Factores pronósticos de remisión en pacientes con leucemia linfoblástica aguda posterior a primer recaída

When the German multicenter trial for the treatment of adult acute lymphoblastic leukemia (ALL) and acute undifferentiated leukemia (AUL) was started in 1978, one of the main objectives was to establish prognostic factors for the definition of groups with increased risk of relapse. At that time, on the basis of large cooperative studies of childhood ALL, children could already be classified as being of standard risk or high risk [1]. It was also of interest whether the prognostic factors might differ when a comparable treatment strategy was applied to adults.

Risk groups in adult acute lymphoblastic leukemia.

In der risikoadaptierten multizentrischen ALL-Therapiestudie des Erwachsenen (02/84) wurde die Wirksamkeit einer Konsolidierungstherapie mit VM26/Ara-C bei Hochrisikopatienten gepruft. Von den 442 rek

Intensivierte Konsolidierungstherapie für ALL-Hochrisikopatienten

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Risk groups in adult acute lymphoblastic leukemia.

Intensivierte Konsolidierungstherapie für ALL-Hochrisikopatienten