Impact of Pediatric vs Adult chemotherapy for high-risk ALL survival
Wang Z, Fan Z, Wu Z, et al. PASS-ALL Study of Pediatric-Inspired versus Adult Chemotherapy Regimens on Survival of High-Risk Philadelphia-Negative B-Cell Acute Lymphoblastic Leukemia with Allogeneic Hematopoietic Stem Cell Transplantation. British Journal of Haematology. 2023; (doi: 10.1111/bjh.19223).
Evidence suggests certain leukemia patients fare better with a pediatric-inspired chemotherapy regimens after hematopoietic stem cell transplantation (allo-HSCT) than an adult chemotherapy regimen. The PASS-ALL study recruited 143 adolescents and young adults with high-risk Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia with comparable baseline properties. A total of 77 enrollees were assigned to pediatric-oriented chemotherapy, and 66 were allocated to adult treatment. Among the 128 participants who underwent allo-HSCT, outcomes measured at 3 years favored the pediatric-inspired regimen. The leukemia-free survival (LFS) rate in the pediatric-inspired group was 72.2% compared with 44.6% in the adult chemotherapy group. The rate of overall survival was 75.3% vs. 64.1% in the adult cohort; and the cumulative incidence of relapse was 25.9% compared with 45.4% in the adult treatment group. Additionally, deeper and durable minimal residual disease was achieved with the pediatric-inspired approach to chemotherapy, according to the researchers, who report this regimen is a predictive factor for LFS.