Defining the course and prognosis of adults with acute lymphocytic leukemia in first salvage after induction failure or short first remission duration

摘要: Modern multiagent, dose-intensive chemotherapy regimens have resulted in cure rates of 80% to 90% childhood acute lymphocytic leukemia (ALL).1,2 Regimens adult ALL patterned after the pediatric programs increased complete response (CR) and long-term survival 30% 50%.3–8 Still, most adults with will die from disease progression. Therefore, there is a need discover new agents anti-ALL activity. Approving for front-line therapy daunting task, because it requires large randomized studies that compare standard versus same addition agent. Because an uncommon (annual US incidence, 1500–3000 cases), such endeavors are almost impossible. discovery regulatory approval relied on development niche indications. Examples include clofarabine second salvage,9,10 nelarabine T-cell salvage,11 tyrosine kinase inhibitors Philadelphia chromosome (Ph)-positive ALL.12,13 Patients primary refractory or first recurrence CR 50% salvage but rate ≤5%.14–17 Their outcome depends several factors, important which duration remission (CRD). It anticipated who short CRD poor outcome, probably as patients salvage18; however, our knowledge, no investigated their outcome. Defining precise course prognosis help speed investigations aimed at this subgroup.