Adults with acute lymphoblastic leukemia (ALL) do worse than children. From 7/2008 to 12/2014, Nordic and Baltic centers treated 1509 consecutive patients aged 1-45 years with Philadelphia chromosome-negative ALL according to the NOPHO ALL2008 without cranial irradiation. Overall, 1022 patients were of age 1-9 years (A), 266 were 10-17 years (B) and 221 were 18-45 years (C). Sixteen patients (three adults) died during induction. All others achieved remission after induction or 1-3 intensive blocks. Subsequently, 45 patients (12 adults) died, 122 patients relapsed (32 adults) with a median time to relapse of 1.6 years and 13 (no adult) developed a second malignancy. Median follow-up time was 4.6 years. Among the three age groups, older patients more often had higher risk ALL due to T-ALL (32%/25%/9%, P<0.001), KMT2A rearrangements (6%/5%/3%, P<0.001) and higher day 29 residual leukemia for B-lineage (P<0.001), but not T-ALL (P=0.53). Event-free survival rates (pEFS_5y) were 89±1% (A), 80±3% (B) and 74±4% (C) with significant differences only for non-high risk groups. Except for thrombosis, pancreatitis and osteonecrosis, the risk of 19 specified toxicities was not enhanced by age above 10 years. In conclusion, a pediatric-based protocol is tolerable and effective for young adults, despite their increased frequency of higher risk features.

中文翻译：

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NOPHO ALL2008治疗1-45岁急性淋巴细胞白血病患者的结果。

患有急性淋巴细胞白血病（ALL）的成人比儿童严重。从7/2008到12/2014，根据NOPHO ALL2008的规定，北欧和波罗的海中心根据NOPHO ALL2008标准对连续1509例年龄在1-45岁的费城染色体阴性ALL患者进行了无颅骨放射治疗。总体而言，年龄为1-9岁（A）的患者为10​​22名，年龄为10-17岁（B）的患者为266名，年龄为18-45岁（C）的患者为221名。16名患者（3名成人）在引产期间死亡。所有其他患者在诱导或1-3次强烈阻滞后均达到缓解。随后，有45位患者（12位成人）死亡，122位复发的患者（32位成人）的中位复发时间为1.6年，另有13位（无成人）发生了第二次恶性肿瘤。中位随访时间为4。6年。在这三个年龄组中，年龄较大的患者由于T-ALL（32％/ 25％/ 9％，P <0.001），KMT2A重排（6％/ 5％/ 3％，P <0.001）和B谱系第29天的剩余白血病（P <0.001），但不是T-ALL（P = 0.53）。无事件生存率（pEFS_5y）分别为89±1％（A），80±3％（B）和74±4％（C），仅非高危人群有显着差异。除血栓，胰腺炎和坏死外，年龄超过10岁并没有增加19种特定毒性的风险。总之，尽管年轻人的高风险特征发生频率增加，但基于儿科的方案对年轻人是可以忍受的和有效的。