SEARCH:   Advanced

Blood, 15 July 2006, Vol. 108, No. 2, pp. 465-472. Prepublished online as a Blood First Edition Paper on March 23, 2006; DOI 10.1182/blood-2005-11-4666. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-11-4666v1 108/2/465    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Lazarus, H. M. Articles by Goldstone, A. H. Search for Related Content PubMed PubMed Citation Articles by Lazarus, H. M. Articles by Goldstone, A. H. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Central nervous system involvement in adult acute lymphoblastic leukemia at diagnosis: results from the international ALL trial MRC UKALL XII/ECOG E2993 Hillard M. Lazarus, Susan M. Richards, Raj Chopra, Mark R. Litzow, Alan K. Burnett, Peter H. Wiernik, Ian M. Franklin, Martin S. Tallman, Lucy Cook, Georgina Buck, I. Jill Durrant, Jacob M. Rowe, Anthony H. Goldstone, for the Medical Research Council (MRC)/National Cancer Research Institute (NCRI) Adult Leukaemia Working Party of the United Kingdom and the Eastern Cooperative Oncology Group From the Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Clinical Trial Service Unit, Oxford, United Kingdom; Christie National Health Service (NHS) Trust Hospital, Manchester, United Kingdom; Mayo Clinic, Rochester, MN; University of Wales, Cardiff, United Kingdom; Our Lady of Mercy Cancer Center, New York Medical College, Bronx; Glasgow Royal Infirmary, United Kingdom; Northwestern University Feinberg School of Medicine, Chicago, IL; University College London (UCL) Hospitals, United Kingdom; and Rambam Medical Center and Technion, Haifa, Israel. Outcome of acute lymphoblastic leukemia (ALL) in adults with central nervous system (CNS) disease at diagnosis is unclear. We treated 1508 de novo ALL patients with 2-phase induction and then high-dose methotrexate with L-asparaginase. Patients up to 50 years old in first remission (CR1) with a matched related donor (MRD) underwent an allogeneic stem cell transplantation (SCT); the remainder in CR1 were randomized to an autologous SCT or intensive consolidation followed by maintenance chemotherapy. Philadelphia chromosome (Ph)–positive patients were offered a matched unrelated donor (MUD) allogeneic SCT. Seventy-seven of 1508 (5%) patients a median age of 29 years had CNS leukemia at presentation; 13 of the 77 (17%) had Ph-positive ALL. Sixty-nine of 77 (90%) patients attained CR1. Thirty-six patients underwent transplantation in CR1 (25 MRD, 5 MUD, and 6 autografts). Eleven of 25 patients with MRD transplantation remain alive at 21 to 102 months, 2 of 5 with MUD at 42 and 71 months, and 1 of 6 with autologous SCT at 35 months. Seven of 27 treated with consolidation/maintenance remain in CR1 56 to 137 months after diagnosis. Overall survival at 5 years was 29% in those with CNS involvement at diagnosis versus 38% (P = .03) for those without. CNS leukemia in adult ALL is uncommon at diagnosis. Adult Ph-negative ALL patients, however, can attain long-term disease-free survival using SCT as well as conventional chemotherapy. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. M. Rowe and A. H. Goldstone How I treat acute lymphocytic leukemia in adults Blood, October 1, 2007; 110(7): 2268 - 2275. [Abstract] [Full Text] [PDF] A. V. Moorman, C. J. Harrison, G. A. N. Buck, S. M. Richards, L. M. Secker-Walker, M. Martineau, G. H. Vance, A. M. Cherry, R. R. Higgins, A. K. Fielding, et al. Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial Blood, April 15, 2007; 109(8): 3189 - 3197. [Abstract] [Full Text] [PDF] C.-H. Pui Central Nervous System Disease in Acute Lymphoblastic Leukemia: Prophylaxis and Treatment Hematology, January 1, 2006; 2006(1): 142 - 146. [Abstract] [Full Text] [PDF]

	Copyright © 2006 by American Society of Hematology         Online ISSN: 1528-0020