Conflict of interests: Nothing to report.
Article first published online: 3 MAR 2012
Copyright © 2012 Wiley Periodicals, Inc.
American Journal of Hematology
Volume 87, Issue 5, pages 472–478, May 2012
How to Cite
Ram, R., Wolach, O., Vidal, L., Gafter-Gvili, A., Shpilberg, O. and Raanani, P. (2012), Adolescents and young adults with acute lymphoblastic leukemia have a better outcome when treated with pediatric-inspired regimens: Systematic review and meta-analysis. Am. J. Hematol., 87: 472–478. doi: 10.1002/ajh.23149
R.R. and O.W. contributed equally to this work.
- Issue published online: 16 APR 2012
- Article first published online: 3 MAR 2012
- Accepted manuscript online: 8 FEB 2012 06:06AM EST
- Manuscript Accepted: 30 JAN 2012
- Manuscript Revised: 7 JAN 2012
- Manuscript Received: 17 DEC 2011
Survival of adults with acute lymphoblastic leukemia (ALL) is inferior to that of pediatric patients. Strategies to improve the outcome of adult population are warranted. This study aims to evaluate the efficacy and safety of pediatric-inspired regimens given to adolescents and young adults (AYA), usually defined as 16–39 years, with ALL. Systematic review and meta-analysis of comparative trials of AYA patients with ALL given induction chemotherapy with either pediatric-inspired regimens or conventional-adult chemotherapy was conducted. Relative risks (RR) with 95% confidence intervals (CIs) were estimated and pooled. Our search yielded 11 trials, including 2,489 patients. AYA patients given pediatric-inspired regimens had a statistically significant lower all cause mortality rate at 3 years (RR 0.58; 95% CI 0.51–0.67). Complete remission rate after induction chemotherapy and event free survival were superior in the pediatric-inspired regimens arm (RR 1.05; 95% CI 1.01–1.10 and RR 1.66; 95% CI 1.39–1.99, respectively). Relapse rate was also lower in patients given pediatric-inspired regimens (RR 0.51; 95% CI 0.39–0.66) with comparable nonrelapse mortality between the two groups (RR 0.53, 95% CI 0.19–1.48). Pediatric-inspired regimens are superior to conventional-adult chemotherapy in AYA ALL patients. Further randomized controlled studies to investigate this approach in adult ALL patients are warranted. Am. J. Hematol. 87:472–478, 2012. © 2012 Wiley Periodicals, Inc.