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Blood, 1 February 2007, Vol. 109, No. 3, pp. 944-950. Prepublished online as a Blood First Edition Paper on October 10, 2006; DOI 10.1182/blood-2006-05-018192. This Article Full Text (PDF) All Versions of this Article: blood-2006-05-018192v1 109/3/944    most recent Alert me when this article is cited Alert me if a correction is posted 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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Fielding, A. K. Articles by Goldstone, A. H Search for Related Content PubMed PubMed Citation Articles by Fielding, A. K. Articles by Goldstone, A. H Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted May 5, 2006 Accepted August 7, 2006 Outcome of 609 adults after relapse of acute lymphoblastic leukaemia (ALL); an MRC UKALL12/ECOG 2993 study Adele K. Fielding*, Susan M Richards, Rajesh Chopra, Hillard M Lazarus, Mark Litzow, Georgina Buck, I Jill Durrant, Selina M Luger, David I Marks, Andrew K McMillan, Martin S Tallman, Jacob M Rowe, and Anthony H Goldstone Royal Free and University College London Medical School, London, UK Clinical Trials Service Unit, Oxford, UK Christie Hospital NHS Trust, Manchester, UK Case Western Reserve University, Cleveland, OH, USA Mayo Clinic, Rochester, MN, USA Clinical Trials Servcie Unit, Oxford, UK University of Pennsylvania Medical Center, Philadelphia, PA, USA Bristol Childrens Hospital, Bristol, UK Nottingham University Hospitals, Nottingham, UK Northwestern University Feinberg School of Medicine, Chicago, IL, USA Rambam Medical Center and Technion, Haifa, Israel University College London Hospitals, London, UK * Corresponding author; email: a.fielding{at}medsch.ucl.ac.uk. The majority of adults with ALL who achieve complete remission (CR) will relapse. We examined the outcome of 609 adults with relapsed ALL, all of whom were previously treated on the MRC UKALL12/ECOG2993 study, where the overall survival (OS) of newly diagnosed patients is 38% (95% confidence interval (CI) = 36-41%) at 5 years. By contrast, OS at 5 years after relapse was 7% (95% CI = 4-9%). Factors predicting a good outcome after salvage therapy were age (OS 12% in patients <20 years versus OS 3% in patients >50 years, 2P <0.00005) and duration of first remission (CR1) (OS 11% in those with CR1 >2 years versus OS 5% in those with CR1 <2 years, 2P <0.00005). Treatment received in CR1 did not influence outcome after relapse. In a very highly selected sub-group of patients who were able to receive HSCT after relapse, some were long-term survivors. We conclude from a large, unselected series with mature follow-up that most adults with relapsed ALL, whatever their prior treatment, cannot be rescued using currently available therapies. Prevention of relapse is the best strategy for long-term survival in this disease. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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