HyperCVAD versus pegaspargase‐containing regimens for Hispanic adults with newly diagnosed B‐cell acute lymphoblastic leukemia

Abstract

AbstractObjectiveThere are significant disparities in outcomes among Hispanic patients with acute lymphoblastic leukemia (ALL). Recent studies have demonstrated favorable outcomes of pegaspargase‐containing ALL regimens (PEG‐CAR) in young adults however, outcomes in Hispanic ethnicity continue to be underreported.MethodsWe evaluated outcomes of newly diagnosed, adult B‐cell ALL Hispanic and non‐Hispanic patients consecutively treated with a PEG‐CAR or HyperCVAD between January 2011 and November 2022. The primary endpoint was event‐free survival (EFS) while secondary endpoints included cumulative incidence of relapse and overall survival (OS).ResultsAmong 105 included patients, 48 (45.7%) were treated with a PEG‐CAR and 57 (54.3%) with HyperCVAD. Median age was 38 years (range, 18–75 years), 61% were Hispanic, and 35.2% had poor‐genetic risk. Hispanic patients demonstrated significantly worse 5‐year EFS with a PEG‐CAR compared to that seen with HyperCVAD (HR, 2.58; 95% CI, 1.32–5.04; p = .006) whereas non‐Hispanic patients had better outcomes with PIR (52.4% vs. 42.0%). Hispanic ethnicity (p = .015) and male sex (p = .019) were independent predictors for poor OS.ConclusionsHispanic patients with B‐cell ALL had worse EFS with a PEG‐CAR as compared with HyperCVAD. Future studies will aim to confirm these findings and establish a tailored treatment approach for this high‐risk population.