Six Patients of Adolescent ALL Treated with Pediatric Chemotherapy after Initial Therapy for Adulthood ALL in Department of Hematology

Abstract

Recently, several studies suggest that pediatric intensive treatment can produce an excellent outcome in adolescent ALL. We evaluated safety and feasibility of pediatric chemotherapy on adolescents with ALL (B-precursor ALL 3, T-ALL 3) between sixteen and nineteen years old who entered our hospital after initial chemotherapy administered by adult hemato-oncologists in their hospital. Grade 3 and 4 adverse events were as follows : neutropenia, anemia, thrombocytopenia, and infection (including two fungal pneumoniae). Osteonecrosis occurred in two patients during maintenance therapy. Two patients in whom therapy was delayed due to fungal pneumoniae relapsed in central nervous system, but they achieved 2nd complete remission. Now all six patients are alive and disease free with a median follow-up time of three and half years. Pediatric chemotherapy regimen can be applied to adolescents without increased risk of serious adverse events except for high incidence of infection and osteonecrosis secondary to steroids. Pediatric chemotherapy regimen appears promising for adolescent ALL to produce better outocome without stem cell transplantation.