Time to post-remission therapy is an independent prognostic factor in adults with acute lymphoblastic leukemia

Leuk Lymphoma. 2008 Aug;49(8):1560-6. doi: 10.1080/10428190802146078.

Abstract

We evaluated patients with newly diagnosed ALL treated at the Cleveland Clinic during the years 1996 through 2005. Cox proportional hazards analysis was used to identify univariate and multivariate correlates of complete remission, overall survival and progression-free survival. On univariate analysis, significant prognostic factors included: age at diagnosis (per 10-year increase), poor risk cytogenetics, time to white blood count recovery, and time from induction chemotherapy (IC) to post-remission therapy (PRT). In patients age <60 years without poor risk cytogenetics, time from IC to PRT (per week increase) was a significant prognostic factor by multivariate analysis and was associated with a decreased progression-free survival [HR 1.27, CI (1.04-1.55), p = 0.019] and decreased overall survival [HR 1.34, CI (1.08-1.67), p = 0.009]. Delayed time from IC to PRT (> or =6.6 weeks) was associated with a statistically worse progression-free and overall survival.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Cytogenetic Analysis
  • Humans
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality*
  • Prognosis
  • Proportional Hazards Models
  • Remission Induction
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Treatment Outcome