Adult all, comparison of chemotherapy protocols

ALL is a hematological malignancy that goes with monoclonal proliferation of immature lymphocyte and myeloid precursors. ALL can be seen both children and adults. In spite of standart protocol for child patients; for adult patients many induction protocol is present. Advantages of these aren't exact. In last years; a pediatric protocol,BFM regimen is used for young adult patients and the results are compared with other adult regimens for side effects, total survivals, desease fee survival and efficacy. Our purpose is finding adult ALL prognosis, comparing induction therapies (including BFM) with each other for efficacy, side effects and survival in our centre. One hundred and twenty three ALL patients who are 17 years old and older ,that registered to Çekirdek database of Hacettepe University Hematology Department since January 2003. Burkitt ALL patients, patients who have insufficient data and took chemotherapy before for the patients who took BFM were excluded (totally 22 patients). For remaining 101 patients; some demographic informations like age, gender, prognostic factors for disease, induction chemotherapies that given to patient, chemotherapy side effects are recorded. Disease free survival, overall survival are calculated and induction protocols are compared with each other. One hundred and one adult ALL patients are studied. Median age was 33,6±14,5 (min:17, max:79). %79,2 of patients had B-ALL, %15,8 had T-ALL, %5 had ph+ ALL. Fifteen percent of the patients had extrameduller involvement. BFM was given to 23 patients, Hyper-CVAD was given to 37 patients and 40 patients took CALGB protocol. Except coagulopaty, there was no significant difference between side effects (p:0,002 for coagulopaty). Coagulopaty was mostly seen in patients who took BFM. Totally complete remission (CR) rate was %73,3, %100 for BFM , %70 for Hyper-CVAD, %81 for CALGB protocol. For all patients and under forty ages, OS time was longer for patients who took BFM protocol (p:0,022)(p:0,014). 3 year survival was %89 for BFM, %41 for Hyper-CVAD and %53 for CALGB. For DFS; BFM was better in both under forty ages and all patients but there was no statistical significance (p:0,101, p:0,166) When we be careful about side affects of L-asparaginase and steroids; BFM protocol is well tolerated and increase survival time in adult patients. KEYWORDS: Adult Acute Lymphoblastic Leukemia, prognosis, adult protocols, BFM