Secondary ALL: OS is worse than in de novo disease across all age groups

  • Zhong J, et al.
  • Clin Lymphoma Myeloma Leuk
  • 30 Apr 2020

  • curated by Pavankumar Kamat
  • Univadis Clinical Summaries
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Takeaway

  • Survival in acute lymphoblastic leukemia (ALL) worsens with increasing age, and OS is poorer in adults with secondary ALL than in those with de novo ALL.

Why this matters

  • Although improved chemotherapy regimens and novel chemotherapy for ALL have boosted complete remission rates, secondary ALL remains common.

Study design

  • Retrospective analysis of 8305 patients with ALL (de novo: 7454; secondary: 851) undergoing chemotherapy, identified in the Surveillance, Epidemiology, and End Results database.
  • Funding: None disclosed.

Key results

  • Women with ALL had a lower mortality risk than men: HR, 0.93 (P<.01>
  • Mortality in black patients was higher than that in whites: HR, 1.29 (P<.001>
  • For both ALL groups, compared with younger patients, mortality risk (HRs) was much higher in patients ages:
    • 45-75 years: 1.82 (P<.001 and>
    • 75 years: 3.85 (P<.001>
  • After propensity matching, OS in the de novo ALL group at years 1, 2, 3, 4, and 5 was higher than in the secondary ALL group across all ages (18-75 years; P<.001>

Limitations

  • Individualized chemotherapy data were not available for analysis.