Final results of a single institution experience with a pediatric-based regimen, the augmented Berlin–Frankfurt–Münster, in adolescents and young adults with acute lymphoblastic leukemia, and comparison to the hyper-CVAD regimen

Michael E. Rytting, Elias J. Jabbour, Jeffrey L. Jorgensen, Farhad Ravandi, Anna R. Franklin, Tapan M. Kadia, Naveen Pemmaraju, Naval G. Daver, Alessandra Ferrajoli, Guillermo Garcia-Manero, Marina Y. Konopleva, Gautam Borthakur, Rebecca Garris, Sa Wang, Sherry Pierce, Kurt Schroeder, Steven M. Kornblau, Deborah A. Thomas, Jorge E. Cortes, Susan M. O'BrienHagop M. Kantarjian

Research output: Contribution to journalArticle

Abstract

Several studies reported improved outcomes of adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) treated with pediatric-based ALL regimens. This prompted the prospective investigation of a pediatric Augmented Berlin–Frankfurt–Münster (ABFM) regimen, and its comparison with hyper-fractionated cyclophosphamide, vincristine, Adriamycin, and dexamethasone (hyper-CVAD) in AYA patients. One hundred and six AYA patients (median age 22 years) with Philadelphia chromosome- (Ph) negative ALL received ABFM from October 2006 through March 2014. Their outcome was compared to 102 AYA patients (median age 27 years), treated with hyper-CVAD at our institution. The complete remission (CR) rate was 93% with ABFM and 98% with hyper-CVAD. The 5-year complete remission duration (CRD) were 53 and 55%, respectively (P = 0.98). The 5-year overall survival (OS) rates were 60 and 60%, respectively. The MRD status on Day 29 and Day 84 of therapy was predictive of long-term outcomes on both ABFM and hyper-CVAD. Severe regimen toxicities with ABFM included hepatotoxicity in 41%, pancreatitis in 11%, osteonecrosis in 9%, and thrombosis in 19%. Myelosuppression-associated complications were most significant with hyper-CVAD. In summary, ABFM and hyper-CVAD resulted in similar efficacy outcomes, but were associated with different toxicity profiles, asparaginase-related with ABFM and myelosuppression-related with hyper-CVAD. Am. J. Hematol. 91:819–823, 2016.

Original languageEnglish (US)
Pages (from-to)819-823
Number of pages5
JournalAmerican Journal of Hematology
Volume91
Issue number8
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

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Vincristine
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Doxorubicin
Cyclophosphamide
Dexamethasone
Young Adult
Pediatrics
Asparaginase
Philadelphia Chromosome
Osteonecrosis
Pancreatitis
Thrombosis
Survival Rate

ASJC Scopus subject areas

  • Hematology

Cite this

Final results of a single institution experience with a pediatric-based regimen, the augmented Berlin–Frankfurt–Münster, in adolescents and young adults with acute lymphoblastic leukemia, and comparison to the hyper-CVAD regimen. / Rytting, Michael E.; Jabbour, Elias J.; Jorgensen, Jeffrey L.; Ravandi, Farhad; Franklin, Anna R.; Kadia, Tapan M.; Pemmaraju, Naveen; Daver, Naval G.; Ferrajoli, Alessandra; Garcia-Manero, Guillermo; Konopleva, Marina Y.; Borthakur, Gautam; Garris, Rebecca; Wang, Sa; Pierce, Sherry; Schroeder, Kurt; Kornblau, Steven M.; Thomas, Deborah A.; Cortes, Jorge E.; O'Brien, Susan M.; Kantarjian, Hagop M.

In: American Journal of Hematology, Vol. 91, No. 8, 01.08.2016, p. 819-823.

Research output: Contribution to journalArticle

Rytting, ME, Jabbour, EJ, Jorgensen, JL, Ravandi, F, Franklin, AR, Kadia, TM, Pemmaraju, N, Daver, NG, Ferrajoli, A, Garcia-Manero, G, Konopleva, MY, Borthakur, G, Garris, R, Wang, S, Pierce, S, Schroeder, K, Kornblau, SM, Thomas, DA, Cortes, JE, O'Brien, SM & Kantarjian, HM 2016, 'Final results of a single institution experience with a pediatric-based regimen, the augmented Berlin–Frankfurt–Münster, in adolescents and young adults with acute lymphoblastic leukemia, and comparison to the hyper-CVAD regimen', American Journal of Hematology, vol. 91, no. 8, pp. 819-823. https://doi.org/10.1002/ajh.24419
Rytting, Michael E. ; Jabbour, Elias J. ; Jorgensen, Jeffrey L. ; Ravandi, Farhad ; Franklin, Anna R. ; Kadia, Tapan M. ; Pemmaraju, Naveen ; Daver, Naval G. ; Ferrajoli, Alessandra ; Garcia-Manero, Guillermo ; Konopleva, Marina Y. ; Borthakur, Gautam ; Garris, Rebecca ; Wang, Sa ; Pierce, Sherry ; Schroeder, Kurt ; Kornblau, Steven M. ; Thomas, Deborah A. ; Cortes, Jorge E. ; O'Brien, Susan M. ; Kantarjian, Hagop M. / Final results of a single institution experience with a pediatric-based regimen, the augmented Berlin–Frankfurt–Münster, in adolescents and young adults with acute lymphoblastic leukemia, and comparison to the hyper-CVAD regimen. In: American Journal of Hematology. 2016 ; Vol. 91, No. 8. pp. 819-823.
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abstract = "Several studies reported improved outcomes of adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) treated with pediatric-based ALL regimens. This prompted the prospective investigation of a pediatric Augmented Berlin–Frankfurt–M{\"u}nster (ABFM) regimen, and its comparison with hyper-fractionated cyclophosphamide, vincristine, Adriamycin, and dexamethasone (hyper-CVAD) in AYA patients. One hundred and six AYA patients (median age 22 years) with Philadelphia chromosome- (Ph) negative ALL received ABFM from October 2006 through March 2014. Their outcome was compared to 102 AYA patients (median age 27 years), treated with hyper-CVAD at our institution. The complete remission (CR) rate was 93{\%} with ABFM and 98{\%} with hyper-CVAD. The 5-year complete remission duration (CRD) were 53 and 55{\%}, respectively (P = 0.98). The 5-year overall survival (OS) rates were 60 and 60{\%}, respectively. The MRD status on Day 29 and Day 84 of therapy was predictive of long-term outcomes on both ABFM and hyper-CVAD. Severe regimen toxicities with ABFM included hepatotoxicity in 41{\%}, pancreatitis in 11{\%}, osteonecrosis in 9{\%}, and thrombosis in 19{\%}. Myelosuppression-associated complications were most significant with hyper-CVAD. In summary, ABFM and hyper-CVAD resulted in similar efficacy outcomes, but were associated with different toxicity profiles, asparaginase-related with ABFM and myelosuppression-related with hyper-CVAD. Am. J. Hematol. 91:819–823, 2016.",
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AU - Jabbour, Elias J.

AU - Jorgensen, Jeffrey L.

AU - Ravandi, Farhad

AU - Franklin, Anna R.

AU - Kadia, Tapan M.

AU - Pemmaraju, Naveen

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AU - Ferrajoli, Alessandra

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AU - Schroeder, Kurt

AU - Kornblau, Steven M.

AU - Thomas, Deborah A.

AU - Cortes, Jorge E.

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AU - Kantarjian, Hagop M.

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