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- W1543255786 abstract "The results of all therapies for adults with acute lymphoblastic leukaemia remain disappointing. Five year survival of the 1929 intensively treated patients in the UKALL XII/ECOG 2993 study was 39% [1]. Chemotherapy is toxic and prolonged; this study reported a 12% 2-year non-relapse mortality in patients without donors. There is a feeling that chemotherapy cannot be pushed much further. Younger (<25-30 years) patients are being treated on more intensive “pediatric” protocols with more asparaginase but there are no mature multicenter data available to evaluate the efficacy of this approach. B cell antibodies are being pursued by a number of groups, nelarabine is being trialled upfront for T cell disease and the early experience with forodesine looks promising but increasing the doses or intensity of the standard drugs seems unlikely to produce significant survival benefits. There has been a better definition of adverse risk factors [2] in recent times, enabling us to target patients likely to fail chemotherapy with our most aggressive therapies. The 5-year overall survival of patients with t(4;11) low hypodiploidy/near triploidy or >5 abnormalities were 24, 22 and 28%, respectively making these patients valid targets for more aggressive approaches. In addition, a major German study of MRD at 9 time points in the first year of acute lymphoblastic leukaemia (ALL) therapy, has found that patients with molecular MRD detectable at week 16 have a very poor outcome (12 vs. 66%) [3] making these patients logical candidates for trials of different approaches including upfront allografting (Table 13-1)." @default.
- W1543255786 created "2016-06-24" @default.
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- W1543255786 date "2009-11-27" @default.
- W1543255786 modified "2023-09-23" @default.
- W1543255786 title "Allogeneic Stem Cell Transplantation for Acute Lymphoblastic Leukaemia in Adults" @default.
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- W1543255786 doi "https://doi.org/10.1007/978-1-59745-478-0_13" @default.
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