Feasibility of Risk-Adapted Therapy in Young Adult Acute Lymphoblastic Leukemia: a Multicenter Trial

Conditions

Acute Lymphoblastic Leukemia

Keywords

Acute lymphoblastic leukemia, adult patient, chemotherapy, stem cell transplantation, Young adult patients

Brief summary

Several prognostic predictors, including baseline ALL features and response to initial therapy, have been described in adult ALL raising the issue of whether these predictors might be redundant and which must be considered for treatment stratification. In the GRAALL-2003 prospective Phase 2 study, we aim to hierarchize the following high-risk factors in Ph-negative ALL patients.

Detailed description

1\) baseline (BL) : WBC30G/L in B-lineage, CNS involvement, MLL-AF4 and E2A-PBX fusions, haploidy/near-triploidy; 2) early response (ER) : corticoresistance after prophase (CsR), chemoresistance at Day 8 (ChR); all CsR and/or ChR patients are planned to receive higher doses of cyclophosphamide (HyperC) at Day 15 of induction; 3) induction response (IR) : no CR or Ig-TCR minimal residual disease (MRD) 10-2 after standard or HyperC induction. Allogeneic stem cell transplantation is proposed to patients with a donor and at least one BL, ER, or IR factor.

Delafoy M, Bonnet MF, Lengliné E, Cieslak A, Touzart A, Balducci E, Simonin M, Lhéritier V, Dourthe ME, Heid-Picard B, Latour S, Dombret H, Rousselot P, Baruchel A, Boissel N, Andrieu GP, Asnafi V.

2025-12-01

10.1182/blood.2025030161

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10.1182/blood-2014-09-599894

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Kheïra Beldjord, Sylvie Chevret, Vahid Asnafi, Françoise Huguet, Marie‐Laure Boulland et al. (25 authors)

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10.1182/blood-2014-01-547695

Adverse prognostic significance of CD20 expression in adults with Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia.

Maury S, Huguet F, Leguay T, Lacombe F, Maynadié M, Girard S, de Labarthe A, Kuhlein E, Raffoux E, Thomas X, Chevallier P, Buzyn A, Delannoy A, Chalandon Y, Vernant JP, Rousselot P, Macintyre E, Ifrah N, Dombret H, Béné MC, Group for Research on Adult Acute Lymphoblastic Leukemia.

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10.3324/haematol.2009.010306

Interventions

PROCEDURECollection of treatment-stratefying prognostic factors

Study design

Allocation

NON_RANDOMIZED

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

15 Years to 59 Years

Healthy volunteers

No

Inclusion criteria

* 15-59 years * acute lymphoblastic leukemia newly diagnosed * signed written informed consent

Exclusion criteria

* Lymphoblastic lymphoma * Acute lymphoblastic leukemia 3 * Chronic Myeloid Leukemia acutisation * Sever organ condition

Design outcomes

Primary

Measure	Time frame
Hierarchical evaluation of baseline poor-prognosis factors and response to initial therapy in younger adults with ALL	—

Secondary

Measure	Time frame
Hematologic and non hematologic toxicity of induction, consolidation and late intensification.	—

Countries

France

Outcome results

None listed