Characteristics and Outcome of Elderly Patients (>55 years) with Acute Lymphoblastic Leukemia

Daniela V. Wenge; Klaus Wethmar; Corinna A. Klar; Hedwig Kolve; Tim Sauer; Linus Angenendt; Georg Evers; Simon Call; Andrea Kerkhoff; Cyrus Khandanpour; Torsten Kessler; Rolf Mesters; Christoph Schliemann; Jan Henrik Mikesch; Christian Reicherts; Monika Brüggemann; Wolfgang E. Berdel; Georg Lenz; Matthias Stelljes

doi:10.3390/cancers14030565

Characteristics and Outcome of Elderly Patients (>55 years) with Acute Lymphoblastic Leukemia

Daniela V. Wenge, Klaus Wethmar, Corinna A. Klar, Hedwig Kolve, Tim Sauer, Linus Angenendt, Georg Evers, Simon Call, Andrea Kerkhoff, Cyrus Khandanpour, Torsten Kessler, Rolf Mesters, Christoph Schliemann, Jan Henrik Mikesch, Christian Reicherts, Monika Brüggemann, Wolfgang E. Berdel, Georg Lenz, Matthias Stelljes^*

^*Corresponding author for this work

Abstract

Prognosis of elderly ALL patients remains dismal. Here, we retrospectively analyzed the course of 93 patients >55 years with B-precursor (n = 88) or T-ALL (n = 5), who received age-adapted, pediatric-inspired chemotherapy regimens at our center between May 2003 and October 2020. The median age at diagnosis was 65.7 years, and surviving patients had a median follow-up of 3.7 years. CR after induction therapy was documented in 76.5%, while the rate of treatment-related death within 100 days was 6.4%. The OS of the entire cohort at 1 and 3 year(s) was 75.2% (95% CI: 66.4-84.0%) and 47.3% (95% CI: 36.8-57.7%), respectively, while the EFS at 1 and 3 years(s) was 59.0% (95% CI: 48.9-69.0%) and 32.9% (95% CI: 23.0-42.8%), respectively. At 3 years, the cumulative incidence (CI) of relapse was 48.3% (95% CI: 38.9-59.9%), and the CI rate of death in CR was 17.3% (95% CI: 10.9-27.5%). Older age and an ECOG > 2 represented risk factors for inferior OS, while BCR::ABL1 status, immunophenotype, and intensity of chemotherapy did not significantly affect OS. We conclude that intensive treatment is feasible in selected elderly ALL patients, but high rates of relapse and death in CR underline the need for novel therapeutic strategies.

Original language	English
Article number	565
Journal	Cancers
Volume	14
Issue number	3
ISSN	2072-6694
DOIs	https://doi.org/10.3390/cancers14030565
Publication status	Published - 01.02.2022

Funding

Conflicts of Interest: K.W.: received honoraria from Pfizer. T.S.: consultancy for Abbvie, Takeda, Astellas, Amgen, Bristol Myers Squibb, Gilead, Pfizer, Ridgeline Discoveries and received honoraria from Pfizer and Abbvie. A.K.: consultancy for Abbvie, Amgen, Bristol Myers Squibb, Takeda, Roche, Celgene, Bayer, speakers bureau: Hexal. C.S.: consultancy for AbbVie, Astellas, AstraZeneca, BMS/Celgene, Jazz, Novartis, Pfizer, and Roche; M.B.: consultant or advisory board member, research support or travel support: Affimed, Amgen, B.D., Incyte, Janssen, Regeneron. W.E.B. received research grants, travel and accommodation support, and consultation honoraria from Amgen and Pfizer. M.S.: consultancy and speakers bureau: Celgene/B.M.S., Novartis, Amgen, M.S.D., Kite/Gilead, consultancy, speakers bureau, and research funding: Pfizer, speakers bureau: Medac. The other authors declared no conflicts of interest.

Research Areas and Centers

Research Area: Luebeck Integrated Oncology Network (LION)
Centers: University Cancer Center Schleswig-Holstein (UCCSH)

DFG Research Classification Scheme

2.22-14 Hematology, Oncology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Wenge, D. V., Wethmar, K., Klar, C. A., Kolve, H., Sauer, T., Angenendt, L., Evers, G., Call, S., Kerkhoff, A., Khandanpour, C., Kessler, T., Mesters, R., Schliemann, C., Mikesch, J. H., Reicherts, C., Brüggemann, M., Berdel, W. E., Lenz, G., & Stelljes, M. (2022). Characteristics and Outcome of Elderly Patients (>55 years) with Acute Lymphoblastic Leukemia. Cancers, 14(3), Article 565. https://doi.org/10.3390/cancers14030565

@article{110e4900b34e4c92a2ce4fdcdc8dbe0e,

title = "Characteristics and Outcome of Elderly Patients (>55 years) with Acute Lymphoblastic Leukemia",

abstract = "Prognosis of elderly ALL patients remains dismal. Here, we retrospectively analyzed the course of 93 patients >55 years with B-precursor (n = 88) or T-ALL (n = 5), who received age-adapted, pediatric-inspired chemotherapy regimens at our center between May 2003 and October 2020. The median age at diagnosis was 65.7 years, and surviving patients had a median follow-up of 3.7 years. CR after induction therapy was documented in 76.5\%, while the rate of treatment-related death within 100 days was 6.4\%. The OS of the entire cohort at 1 and 3 year(s) was 75.2\% (95\% CI: 66.4-84.0\%) and 47.3\% (95\% CI: 36.8-57.7\%), respectively, while the EFS at 1 and 3 years(s) was 59.0\% (95\% CI: 48.9-69.0\%) and 32.9\% (95\% CI: 23.0-42.8\%), respectively. At 3 years, the cumulative incidence (CI) of relapse was 48.3\% (95\% CI: 38.9-59.9\%), and the CI rate of death in CR was 17.3\% (95\% CI: 10.9-27.5\%). Older age and an ECOG > 2 represented risk factors for inferior OS, while BCR::ABL1 status, immunophenotype, and intensity of chemotherapy did not significantly affect OS. We conclude that intensive treatment is feasible in selected elderly ALL patients, but high rates of relapse and death in CR underline the need for novel therapeutic strategies.",

author = "Wenge, \{Daniela V.\} and Klaus Wethmar and Klar, \{Corinna A.\} and Hedwig Kolve and Tim Sauer and Linus Angenendt and Georg Evers and Simon Call and Andrea Kerkhoff and Cyrus Khandanpour and Torsten Kessler and Rolf Mesters and Christoph Schliemann and Mikesch, \{Jan Henrik\} and Christian Reicherts and Monika Br{\"u}ggemann and Berdel, \{Wolfgang E.\} and Georg Lenz and Matthias Stelljes",

note = "Publisher Copyright: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2022",

month = feb,

day = "1",

doi = "10.3390/cancers14030565",

language = "English",

volume = "14",

journal = "Cancers",

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Wenge, DV, Wethmar, K, Klar, CA, Kolve, H, Sauer, T, Angenendt, L, Evers, G, Call, S, Kerkhoff, A, Khandanpour, C, Kessler, T, Mesters, R, Schliemann, C, Mikesch, JH, Reicherts, C, Brüggemann, M, Berdel, WE, Lenz, G & Stelljes, M 2022, 'Characteristics and Outcome of Elderly Patients (>55 years) with Acute Lymphoblastic Leukemia', Cancers, vol. 14, no. 3, 565. https://doi.org/10.3390/cancers14030565

TY - JOUR

T1 - Characteristics and Outcome of Elderly Patients (>55 years) with Acute Lymphoblastic Leukemia

AU - Wenge, Daniela V.

AU - Wethmar, Klaus

AU - Klar, Corinna A.

AU - Kolve, Hedwig

AU - Sauer, Tim

AU - Angenendt, Linus

AU - Evers, Georg

AU - Call, Simon

AU - Kerkhoff, Andrea

AU - Khandanpour, Cyrus

AU - Kessler, Torsten

AU - Mesters, Rolf

AU - Schliemann, Christoph

AU - Mikesch, Jan Henrik

AU - Reicherts, Christian

AU - Brüggemann, Monika

AU - Berdel, Wolfgang E.

AU - Lenz, Georg

AU - Stelljes, Matthias

PY - 2022/2/1

Y1 - 2022/2/1

N2 - Prognosis of elderly ALL patients remains dismal. Here, we retrospectively analyzed the course of 93 patients >55 years with B-precursor (n = 88) or T-ALL (n = 5), who received age-adapted, pediatric-inspired chemotherapy regimens at our center between May 2003 and October 2020. The median age at diagnosis was 65.7 years, and surviving patients had a median follow-up of 3.7 years. CR after induction therapy was documented in 76.5%, while the rate of treatment-related death within 100 days was 6.4%. The OS of the entire cohort at 1 and 3 year(s) was 75.2% (95% CI: 66.4-84.0%) and 47.3% (95% CI: 36.8-57.7%), respectively, while the EFS at 1 and 3 years(s) was 59.0% (95% CI: 48.9-69.0%) and 32.9% (95% CI: 23.0-42.8%), respectively. At 3 years, the cumulative incidence (CI) of relapse was 48.3% (95% CI: 38.9-59.9%), and the CI rate of death in CR was 17.3% (95% CI: 10.9-27.5%). Older age and an ECOG > 2 represented risk factors for inferior OS, while BCR::ABL1 status, immunophenotype, and intensity of chemotherapy did not significantly affect OS. We conclude that intensive treatment is feasible in selected elderly ALL patients, but high rates of relapse and death in CR underline the need for novel therapeutic strategies.

AB - Prognosis of elderly ALL patients remains dismal. Here, we retrospectively analyzed the course of 93 patients >55 years with B-precursor (n = 88) or T-ALL (n = 5), who received age-adapted, pediatric-inspired chemotherapy regimens at our center between May 2003 and October 2020. The median age at diagnosis was 65.7 years, and surviving patients had a median follow-up of 3.7 years. CR after induction therapy was documented in 76.5%, while the rate of treatment-related death within 100 days was 6.4%. The OS of the entire cohort at 1 and 3 year(s) was 75.2% (95% CI: 66.4-84.0%) and 47.3% (95% CI: 36.8-57.7%), respectively, while the EFS at 1 and 3 years(s) was 59.0% (95% CI: 48.9-69.0%) and 32.9% (95% CI: 23.0-42.8%), respectively. At 3 years, the cumulative incidence (CI) of relapse was 48.3% (95% CI: 38.9-59.9%), and the CI rate of death in CR was 17.3% (95% CI: 10.9-27.5%). Older age and an ECOG > 2 represented risk factors for inferior OS, while BCR::ABL1 status, immunophenotype, and intensity of chemotherapy did not significantly affect OS. We conclude that intensive treatment is feasible in selected elderly ALL patients, but high rates of relapse and death in CR underline the need for novel therapeutic strategies.

UR - https://www.scopus.com/pages/publications/85123511064

U2 - 10.3390/cancers14030565

DO - 10.3390/cancers14030565

M3 - Journal articles

AN - SCOPUS:85123511064

SN - 2072-6694

VL - 14

JO - Cancers

JF - Cancers

IS - 3

M1 - 565

ER -

Characteristics and Outcome of Elderly Patients (>55 years) with Acute Lymphoblastic Leukemia

Abstract

Funding

Research Areas and Centers

DFG Research Classification Scheme

UN SDGs

Access to Document

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