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Survival in adult acute lymphoblastic leukaemia (ALL): A report from the Swedish ALL Registry
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.ORCID iD: 0000-0002-1737-5568
Skane Univ Hosp, Dept Haematol Oncol & Radiophys, Lund, Sweden.
Univ Hosp Linkoping, Dept Haematol, Linkoping, Sweden.
Sahlgrens Univ Hosp, Sect Haematol & Coagulat, Dept Med, Gothenburg, Sweden.
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2019 (English)In: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 103, no 2, p. 88-98Article in journal (Refereed) Published
Abstract [en]

Objectives: As new, effective therapies emerge for acute lymphoblastic leukaemia (ALL), the results of clinical trials need to relate to standard of care.

Methods: We used the population-based Swedish ALL Registry to evaluate characteristics, treatment and long-term outcome in 933 patients with diagnosis between 1997 and 2015.

Results: The median age was 53 years. The frequency of Philadelphia (Ph)-positive leukaemia was 34% of examined B-ALL with a peak incidence at 50-59 years. Five-year overall survival (OS) improved between 1997-2006 and 2007-2015; in patients 18-45 years from 50% (95% CI 43-57) to 65% (95% CI 58-72), 46-65 years from 25% (95% CI 18-32) to 46% (95% CI 37-55) and >65 years from 7% (95% CI 2.6-11) to 11% (95% CI 5.9-16) (P < 0.05). Men with Ph-neg B-ALL 46-65 years had inferior OS compared with women (P < 0.01). Standardised mortality ratio was 5.7 (95% CI 5.0-6.3) for patients who survived 5 years from diagnosis. In multivariable analysis, Ph-positive disease was not associated with impaired prognosis but with lower risk of death in 2007-2015.

Conclusions: In a population-based cohort, OS has improved in adult ALL, especially for Ph-positive disease but for middle-aged men with Ph-negative B-ALL outcome was poor. Cure without late toxicity or relapse is still desired.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 103, no 2, p. 88-98
Keywords [en]
acute lymphoblastic leukaemia, adult, Philadelphia-positive
National Category
Hematology
Identifiers
URN: urn:nbn:se:uu:diva-390495DOI: 10.1111/ejh.13247ISI: 000475475200003PubMedID: 31074910OAI: oai:DiVA.org:uu-390495DiVA, id: diva2:1341943
Available from: 2019-08-12 Created: 2019-08-12 Last updated: 2019-09-17Bibliographically approved

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