Acute Lymphocytic Leukemia in Adults: A Retrospective Study and Analysis of Current Management Options
Section snippets
Patients.
From a computer database of patients examined at the Mayo Clinic between 1982 and 1992, 384 with a diagnosis of ALL were identified. Historical review of these cases revealed 90 patients who were older than 15 years of age (adults) and fulfilled the criteria for a laboratory diagnosis of ALL (characteristic morphologic features, negative results of myeloid cytochemical studies [myeloperoxidase and nonspecific esterase], and” presence of terminal deoxynucleotidyltransferase). We used these
RESULTS
During a median follow-up of more than 7 years, the overall percentage of survival of the 90 adult patients was 23%. All 10 untreated patients had a median survival of 4 months (range, 0 to 18). These patients were untreated because of a debilitated state or refusal by the patient. The overall percentage of survival of the 80 patients who received induction chemotherapy was 25% (Fig. 1). For this group of patients, age, leukocyte count, cytogenetic patterns, leukemic phenotype, and time to
DISCUSSION
In this retrospective analysis of treatment outcome of adult patients with ALL, the major findings were (1) the superior long-term disease-free survival rate (80%) in “adolescents” (those 16 and 17 years old), (2) the dismal outcome (long-term disease-free survival rate of less than 10%) of “adults” (those 18 years old or older) who received chemotherapy only, and (3) the possible improvement in the duration of CR (100% durable first CR) with use of allogeneic BMT. In addition, currently
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Current address: University of California San Francisco, Fresno, California.
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Current address: Syntex Corporation, Palo Alto, California.