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

47 Scopus citations

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

ASJC Scopus subject areas

  • Hematology

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    Rytting, M. E., Jabbour, E. J., Jorgensen, J. L., Ravandi, F., Franklin, A. R., Kadia, T. M., Pemmaraju, N., Daver, N. G., Ferrajoli, A., Garcia-Manero, G., Konopleva, M. Y., Borthakur, G., Garris, R., Wang, S., Pierce, S., Schroeder, K., Kornblau, S. M., Thomas, D. A., Cortes, J. E., ... Kantarjian, H. M. (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, 91(8), 819-823. https://doi.org/10.1002/ajh.24419