학술논문

CAG regimen for refractory or relapsed adult T‐cell acute lymphoblastic leukemia: A retrospective, multicenter, cohort study
Document Type
Report
Source
Cancer Medicine. June 3, 2020, Vol. 9 Issue 15, p5327, 8 p.
Subject
Oncology, Experimental -- Analysis
T cells -- Analysis
Antineoplastic agents -- Analysis
Acute lymphocytic leukemia -- Care and treatment -- Prognosis
Cancer -- Research
Antimitotic agents -- Analysis
Language
English
Abstract
Adult patients with relapsed or refractory T‐cell acute lymphoblastic leukemia (R/R‐T‐ALL) have extremely poor prognosis, representing an urgent unmet medical need. Finding an optimal salvage regimen to bridge transplantation is a priority. The CAG (cytarabine, aclarubicin, and G‐CSF) regimen was initially used by one group in China, showing unexpectedly promising results in 11 R/R‐T‐ALL patients. Here, we report the multicenter results of 41 patients who received the CAG regimen as salvage therapy. After one cycle of the CAG regimen, complete remission and partial remission were achieved in 33 (80.5%) and two (4.9%) patients, respectively. Failure to respond was observed in six patients (14.6%). Early T‐cell precursor (ETP) (n = 26) and non‐ETP (n = 15) patients had a similar CR rate (80.8% vs 80.0%, P =.95). Among 41 patients, allo‐HSCT was successfully performed in 27 (66%) patients (22 in CR and 5 in non‐CR). With a median follow‐up time of 12 months, the estimated 2‐year overall survival and event‐free survival were 68.8% (95% CI, 47.3%‐83.0%) and 56.5% (95% CI, 37.1%‐71.9%), respectively. The CAG regimen was well‐tolerated, and no early death occurred. Our multicenter results show that the CAG regimen is highly effective and safe, representing a novel choice for adult patients with R/R‐T‐ALL and providing a better bridge to transplantation.
INTRODUCTION Adult T‐cell acute lymphoblastic leukemia (T‐ALL) accounts for approximately 25% of adult ALL cases and has inferior outcomes.[sup.1‐3] Although the outcomes have improved slowly in recent years for newly [...]