Higher Survival Advantage With Hyper-CVAD Chemotherapy Regimen Before Allogeneic Stem Cell Transplantation In Patients With High Risk Adult Acute Lymphoblastic Leukemia: Two-Center Experience

Abstract

While promising results have been achieved in the treatment of childhood, the optimal initial treatment for adult acute lymphoblastic leukemia (ALL) has not yet been defined. Hyper-CVAD has become a widely used treatment for approximately 2 decades in the treatment of adult ALL. We conducted a retrospective analysis of 30 patients treated with Hyper-CVAD at two centers between 2014 and 2020. In all (n:30) patients treated with Hyper-CVAD, CR rate was 86.7%, induction mortality was 10%, refractory disease was 3.3%, the median OS was 38 months (95% CI 7.78–68.2 months), the median DFS was 29 months (95% CI 9–49 months), the 2-year OS rate was 56.5%, and the 2-year DFS was rate 56.7%. For standard risk (n: 12) ALL patients, the median OS was 20 months (95% CI 0–43 months), and median DFS was 7 months (95% CI 0–25 months). For high risk (n: 18) ALL patients, the median OS was 38 months (95% CI 0–76 months), and median DFS was not reached. These results indicate that Hyper-CVAD regimen should be especially considered as an option for induction treatment of adult patients with high risk ALL whom are newly diagnosed and eligible for allogeneic stem cell transplantation (ASCT).