International Journal of Hematology and Oncology 2018, Vol 28, Num 4 Page(s): 254-260
Pediatric Chemotherapeutic Regimen (BFM-95) is Superior for Overall Survival in Adult Acute Lymphoblastic Leukemia

Ayse Muge KARCIOGLU1, Mufide OKAY2, Yahya BUYUKASIK2, Umit Yavuz MALKAN3, Nilgun SAYINALP2, Haluk DEMIROGLU2, Hakan GOKER2, Salih AKSU2, Osman Ilhami OZCEBE2, Ibrahim Celalettin HAZNEDAROGLU2

1Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Ankara, TURKEY
2Hacettepe University, Faculty of Medicine, Department of Hematology, Ankara, TURKEY
3University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Hematology, Ankara, TURKEY

Keywords: Adult Acute Lymphoblastic Leukemia, Prognosis, adult protocol, BFM
Acute lymphoblastic leukemia (ALL) is a neoplastic disease characterized by clonal malignant proliferation of the lymphoid blast cells. The aim of this study is to compare chemotherapy, pediatric regimen BFM-95 protocol with adult ALL protocols in our patient cohort. We retrospectively collected data of patients aged 17 and older who were registered to database of our Hematology Department
as acute lymphocytic leukemia between the years 2003-2016. Demographic data,chemotherapy protocols,side effects due to chemotherapy,disease free survivals (DFS) and overall survivals(OS) of remaining 101 patients were compared. The mean age of the patients was 33.6±14.5 ages.80% of patients were B-ALL,15% were T-ALL, 5% were in Ph+ ALL phenotype.Coagulopathy was seen more in patients receiving BFM-95 (p= 0.002). There was no significant difference among the protocols except for the coagulopathy.
The complete remission rate (CR) was 100% in the BFM-95 protocol group, 70% in the Hyper-CVAD group and 60% in the CALGB receiving group. Three-year OS rate was 89% in patients receiving BFM-95, 41% in patients receiving Hyper-CVAD and 53% in CALGB group (p= 0.022).Since patients receiving BFM-95 are under 40 years of age, in order to be able to evaluate the BFM-95 protocol more clearly, OS is examined separately in patients under 40 years of age and it was found that OS was again significantly
high in BFM-95 group (p= 0.014). The BFM-95 protocol has been shown to be well tolerated and to improve survival in adult patients when careful in terms of L-asparaginase and steroid-dependent side effects.