Olivier-Gougenheim Laura, Arfeuille Chloe, Suciu Stefan, Sirvent Nicolas, Plat Geneviève, Ferster Alina, de Moerloose Barbara, Domenech Carine, Uyttebroeck Anne, Rohrlich Pierre-Simon, Cavé Helene, Bertrand Yves
Institute of Pediatric Hematology and Oncology, Hospices Civils de Lyon, Claude Bernard Lyon I University, Lyon, France.
Department of Genetic Biochemistry, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France.
Hematol Oncol. 2020 Dec;38(5):763-772. doi: 10.1002/hon.2791. Epub 2020 Sep 5.
Over the years, the prognosis of adolescents treated for acute lymphoblastic leukemia (ALL) has improved. However, this age group still represents a challenge with an overall survival (OS) of 60% compared to 85% in younger children. Herein, we report the outcome of adolescents treated in the European Organisation for Research and Treatment of Cancer (EORTC) 58951 clinical trial. EORTC 58951 clinical trial included patients with de novo ALL between 1998 and 2008. For this study, we analyzed data of all adolescents between 15 and under 18. Data from 97 adolescents were analyzed, 70 had B-lineage and 27 had T-lineage ALL. The 8-year event-free survival (EFS) and OS for the B-cell precursor ALL cases were 72.3% (59.4%-81.7%) and 80.8% (67.4%-89.1%), respectively. For the T-lineage, the 8-year EFS and OS were 57.4% (36.1%-74.0%) and 59.0% (36.1%-76.2%), respectively. "B-other" ALL, defined as BCP-ALL lacking any known recurrent genetic abnormalities were more frequent in our adolescent population (52.8%) than in younger children (27.1%). Outcome of adolescents in the EORTC 58951 study is supporting the findings that adolescents have better outcome in pediatric compared to adults' trials. Nevertheless, in pediatric studies, adolescents still have a worse prognosis than younger children. Despite the fact that specific unfavorable characteristics may be linked to the adolescent population, a careful study and characterization of adolescents "B-other" genetic abnormalities in ALL is critical to improve the outcome of this population.
多年来，接受急性淋巴细胞白血病（ALL）治疗的青少年的预后有所改善。然而，与年幼儿童85%的总生存率相比，这个年龄组的总生存率仍为60%，仍是一个挑战。在此，我们报告欧洲癌症研究与治疗组织（EORTC）58951临床试验中青少年患者的治疗结果。EORTC 58951临床试验纳入了1998年至2008年间初发ALL患者。在本研究中，我们分析了所有15岁至未满18岁青少年的数据。分析了97名青少年的数据，其中70例为B系ALL，27例为T系ALL。B细胞前体ALL病例的8年无事件生存率（EFS）和总生存率（OS）分别为72.3%（59.4%-81.7%）和80.8%（67.4%-89.1%）。对于T系ALL，8年EFS和OS分别为57.4%（36.1%-74.0%）和59.0%（36.1%-76.2%）。“B-其他”ALL定义为缺乏任何已知复发性基因异常的BCP-ALL，在我们的青少年人群中（52.8%）比年幼儿童（27.1%）更常见。EORTC 58951研究中青少年的治疗结果支持了以下发现：与成人试验相比，青少年在儿科试验中的治疗结果更好。然而，在儿科研究中，青少年的预后仍比年幼儿童差。尽管特定的不良特征可能与青少年人群有关，但仔细研究和鉴定青少年ALL中“B-其他”基因异常对于改善该人群的治疗结果至关重要。
