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Acute Lymphoblastic Leukemia in Routine Practice: A Turkish Multicenter Study.

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Title: Acute Lymphoblastic Leukemia in Routine Practice: A Turkish Multicenter Study.
Alternate Title: Rutin Uygulamada Akut Lenfoblastik Lösemi: Türkiye'den Çok Merkezli Bir Çalışma.
Authors: Çiftçiler, Rafiye1 rafiyesarigul@gmail.com, Sevindik, Ömür Gökmen2, Tekgündüz, Ali İrfan Emre3, Erkurt, Mehmet Ali4, Vural, Filiz5, Turgut, Burhan6, Kaynar, Leylagül7, Payzın, Bahriye8, Doğu, Mehmet Hilmi9, Karakuş, Volkan10, Altuntaş, Fevzi11, Büyükaşık, Yahya1,2, Demirkan, Fatih12
Source: Turkish Journal of Hematology. 2019, Vol. 36 Issue 3, p169-177. 9p.
Subject Terms: *LYMPHOBLASTIC leukemia treatment, *LYMPHOBLASTIC leukemia prognosis, *LYMPHOBLASTIC leukemia diagnosis, *B cell lymphoma, *CONFIDENCE intervals, *HEMATOPOIETIC stem cell transplantation, *LYMPHOBLASTIC leukemia, *EVALUATION of medical care, *MEDICAL cooperation, *RESEARCH, *DISEASE remission, *RETROSPECTIVE studies, *SYMPTOMS
Geographic Terms: TURKEY
Abstract (English): Objective: Significant developments occurred in the clinical management of acute lymphoblastic leukemia (ALL) in adults in recent decades. However, treatment results are still not satisfactory, especially in routine practice. The objective of this study was to evaluate the general clinical features, treatment details, and outcomes of a large group of patients followed in multiple centers in Turkey with a diagnosis of ALL. Materials and Methods: A retrospective analysis of the data of patients with ALL was made, the patients having been diagnosed and treated between January 2003 and June 2017 by different protocols in the hematology clinics of ten different centers. A total of 288 patients, aged between 17 and 76 years old, were included in the study. In this retrospective multicenter analysis of patients with ALL, classification of patients was performed based on treatment period, Philadelphia chromosome positivity, treatment regimen, and administration of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Results: The majority of cases were B-cell in origin, while 224 patients had B-ALL and 64 of the patients had T-ALL. Median follow-up duration for all patients was 18.2 months (range: 0.03-161 months). Philadelphia chromosome positivity was determined in 49 patients (21.9%), and 54 patients (18.8%) were receiving allo-HSCT. After induction chemotherapy, 219 patients (76.0%) achieved complete remission, 32 patients (11.2%) were evaluated as treatment refractory, and 37 patients (12.8%) were deceased. Median overall survival was 47.7 months (95% confidence interval: 36.1-59.2) and median disease-free survival was 23.4 months (95% confidence interval: 6.7-40.0) for all patients. Conclusion: Multicenter studies are extremely important for defining the specific clinical features of a particular disease. The results of this study will make a significant contribution to the literature as they reflect real-life data providing valuable information about the Turkish ALL patient profile. [ABSTRACT FROM AUTHOR]
Abstract (Turkish): Amaç: Son yıllarda erişkinlerde akut lenfoblastik löseminin (ALL) tedavi yönetiminde önemli gelişmeler meydana gelmiştir. Bununla birlikte, özellikle rutin uygulamada tedavi sonuçları hala tatmin edici değildir. Çalışmanın amacı, Türkiye'de birden fazla merkezde takip edilen geniş bir ALL hasta grubunun genel klinik özelliklerini, tedavi özelliklerini ve sağkalım sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Ocak 2003 ile Haziran 2017 tarihleri arasında on farklı merkezdeki hematoloji kliniğinde tanı konulan ve farklı protokollerle tedavi edilen ALL hastalarının verilerinin retrospektif analizi yapıldı. Çalışmaya yaşları 17 ile 76 arasında değişen toplam 288 hasta dahil edildi. Bu çalışmada ALL'li hastalar tedavi periyoduna, Philadelphia kromozom pozitifliğine, tedavi protokolü ve allojenik hematopoetik kök hücre nakli (AHKHN) yapılıp yapılmamasına göre sınıflandırıldı. Bulgular: Olguların 224'ü B-ALL, 64'ü T-ALL idi. Tüm hastalar için ortanca takip süresi 18,2 ay (dağılım, 0,03-161 ay) idi. Philadelphia kromozomu (Ph+) pozitifliği 49 (%21,9) hastada saptandı ve 54 hastaya (%18,8) AHKHN yapıldığı izlendi. İndüksiyon kemoterapisinden sonra 219 hasta (%76) tam remisyona girdi, 32 hasta tedaviye refrakter (%11,2) olarak değerlendirildi, 37 hastada ise (%12,8) mortalite gözlendi. Ortanca genel sağkalım 47,7 ay (%95 güven aralığı: 36,1-59,2) ve ortanca hastalıksız sağkalım tüm hastalar için 23,4 ay (%95 güven aralığı: 6,7-40,0) idi. Sonuç: Sonuç olarak, çok merkezli çalışmalar, belirli bir hastalığın spesifik klinik özelliklerini tanımlamak için büyük öneme sahiptir. Bu çalışmanın sonuçları, Türk ALL hasta profili hakkında değerli bilgiler sağlayan gerçek hayat verilerini yansıttığı için literatüre önemli bir katkı sağlayacaktır. [ABSTRACT FROM AUTHOR]
Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Acute Lymphoblastic Leukemia in Routine Practice: A Turkish Multicenter Study.
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  Data: Rutin Uygulamada Akut Lenfoblastik Lösemi: Türkiye'den Çok Merkezli Bir Çalışma.
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  Data: <searchLink fieldCode="AR" term="%22Çiftçiler%2C+Rafiye%22">Çiftçiler, Rafiye</searchLink><relatesTo>1</relatesTo><i> rafiyesarigul@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Sevindik%2C+Ömür+Gökmen%22">Sevindik, Ömür Gökmen</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Tekgündüz%2C+Ali+İrfan+Emre%22">Tekgündüz, Ali İrfan Emre</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Erkurt%2C+Mehmet+Ali%22">Erkurt, Mehmet Ali</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Vural%2C+Filiz%22">Vural, Filiz</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Turgut%2C+Burhan%22">Turgut, Burhan</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Kaynar%2C+Leylagül%22">Kaynar, Leylagül</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Payzın%2C+Bahriye%22">Payzın, Bahriye</searchLink><relatesTo>8</relatesTo><br /><searchLink fieldCode="AR" term="%22Doğu%2C+Mehmet+Hilmi%22">Doğu, Mehmet Hilmi</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22Karakuş%2C+Volkan%22">Karakuş, Volkan</searchLink><relatesTo>10</relatesTo><br /><searchLink fieldCode="AR" term="%22Altuntaş%2C+Fevzi%22">Altuntaş, Fevzi</searchLink><relatesTo>11</relatesTo><br /><searchLink fieldCode="AR" term="%22Büyükaşık%2C+Yahya%22">Büyükaşık, Yahya</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Demirkan%2C+Fatih%22">Demirkan, Fatih</searchLink><relatesTo>12</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Turkish+Journal+of+Hematology%22">Turkish Journal of Hematology</searchLink>. 2019, Vol. 36 Issue 3, p169-177. 9p.
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  Data: *<searchLink fieldCode="DE" term="%22LYMPHOBLASTIC+leukemia+treatment%22">LYMPHOBLASTIC leukemia treatment</searchLink><br />*<searchLink fieldCode="DE" term="%22LYMPHOBLASTIC+leukemia+prognosis%22">LYMPHOBLASTIC leukemia prognosis</searchLink><br />*<searchLink fieldCode="DE" term="%22LYMPHOBLASTIC+leukemia+diagnosis%22">LYMPHOBLASTIC leukemia diagnosis</searchLink><br />*<searchLink fieldCode="DE" term="%22B+cell+lymphoma%22">B cell lymphoma</searchLink><br />*<searchLink fieldCode="DE" term="%22CONFIDENCE+intervals%22">CONFIDENCE intervals</searchLink><br />*<searchLink fieldCode="DE" term="%22HEMATOPOIETIC+stem+cell+transplantation%22">HEMATOPOIETIC stem cell transplantation</searchLink><br />*<searchLink fieldCode="DE" term="%22LYMPHOBLASTIC+leukemia%22">LYMPHOBLASTIC leukemia</searchLink><br />*<searchLink fieldCode="DE" term="%22EVALUATION+of+medical+care%22">EVALUATION of medical care</searchLink><br />*<searchLink fieldCode="DE" term="%22MEDICAL+cooperation%22">MEDICAL cooperation</searchLink><br />*<searchLink fieldCode="DE" term="%22RESEARCH%22">RESEARCH</searchLink><br />*<searchLink fieldCode="DE" term="%22DISEASE+remission%22">DISEASE remission</searchLink><br />*<searchLink fieldCode="DE" term="%22RETROSPECTIVE+studies%22">RETROSPECTIVE studies</searchLink><br />*<searchLink fieldCode="DE" term="%22SYMPTOMS%22">SYMPTOMS</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22TURKEY%22">TURKEY</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Objective: Significant developments occurred in the clinical management of acute lymphoblastic leukemia (ALL) in adults in recent decades. However, treatment results are still not satisfactory, especially in routine practice. The objective of this study was to evaluate the general clinical features, treatment details, and outcomes of a large group of patients followed in multiple centers in Turkey with a diagnosis of ALL. Materials and Methods: A retrospective analysis of the data of patients with ALL was made, the patients having been diagnosed and treated between January 2003 and June 2017 by different protocols in the hematology clinics of ten different centers. A total of 288 patients, aged between 17 and 76 years old, were included in the study. In this retrospective multicenter analysis of patients with ALL, classification of patients was performed based on treatment period, Philadelphia chromosome positivity, treatment regimen, and administration of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Results: The majority of cases were B-cell in origin, while 224 patients had B-ALL and 64 of the patients had T-ALL. Median follow-up duration for all patients was 18.2 months (range: 0.03-161 months). Philadelphia chromosome positivity was determined in 49 patients (21.9%), and 54 patients (18.8%) were receiving allo-HSCT. After induction chemotherapy, 219 patients (76.0%) achieved complete remission, 32 patients (11.2%) were evaluated as treatment refractory, and 37 patients (12.8%) were deceased. Median overall survival was 47.7 months (95% confidence interval: 36.1-59.2) and median disease-free survival was 23.4 months (95% confidence interval: 6.7-40.0) for all patients. Conclusion: Multicenter studies are extremely important for defining the specific clinical features of a particular disease. The results of this study will make a significant contribution to the literature as they reflect real-life data providing valuable information about the Turkish ALL patient profile. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Turkish)
  Group: Ab
  Data: Amaç: Son yıllarda erişkinlerde akut lenfoblastik löseminin (ALL) tedavi yönetiminde önemli gelişmeler meydana gelmiştir. Bununla birlikte, özellikle rutin uygulamada tedavi sonuçları hala tatmin edici değildir. Çalışmanın amacı, Türkiye'de birden fazla merkezde takip edilen geniş bir ALL hasta grubunun genel klinik özelliklerini, tedavi özelliklerini ve sağkalım sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Ocak 2003 ile Haziran 2017 tarihleri arasında on farklı merkezdeki hematoloji kliniğinde tanı konulan ve farklı protokollerle tedavi edilen ALL hastalarının verilerinin retrospektif analizi yapıldı. Çalışmaya yaşları 17 ile 76 arasında değişen toplam 288 hasta dahil edildi. Bu çalışmada ALL'li hastalar tedavi periyoduna, Philadelphia kromozom pozitifliğine, tedavi protokolü ve allojenik hematopoetik kök hücre nakli (AHKHN) yapılıp yapılmamasına göre sınıflandırıldı. Bulgular: Olguların 224'ü B-ALL, 64'ü T-ALL idi. Tüm hastalar için ortanca takip süresi 18,2 ay (dağılım, 0,03-161 ay) idi. Philadelphia kromozomu (Ph+) pozitifliği 49 (%21,9) hastada saptandı ve 54 hastaya (%18,8) AHKHN yapıldığı izlendi. İndüksiyon kemoterapisinden sonra 219 hasta (%76) tam remisyona girdi, 32 hasta tedaviye refrakter (%11,2) olarak değerlendirildi, 37 hastada ise (%12,8) mortalite gözlendi. Ortanca genel sağkalım 47,7 ay (%95 güven aralığı: 36,1-59,2) ve ortanca hastalıksız sağkalım tüm hastalar için 23,4 ay (%95 güven aralığı: 6,7-40,0) idi. Sonuç: Sonuç olarak, çok merkezli çalışmalar, belirli bir hastalığın spesifik klinik özelliklerini tanımlamak için büyük öneme sahiptir. Bu çalışmanın sonuçları, Türk ALL hasta profili hakkında değerli bilgiler sağlayan gerçek hayat verilerini yansıttığı için literatüre önemli bir katkı sağlayacaktır. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.4274/tjh.galenos.2019.2019.0008
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        Text: English
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        StartPage: 169
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      – SubjectFull: TURKEY
        Type: general
      – SubjectFull: LYMPHOBLASTIC leukemia treatment
        Type: general
      – SubjectFull: LYMPHOBLASTIC leukemia prognosis
        Type: general
      – SubjectFull: LYMPHOBLASTIC leukemia diagnosis
        Type: general
      – SubjectFull: B cell lymphoma
        Type: general
      – SubjectFull: CONFIDENCE intervals
        Type: general
      – SubjectFull: HEMATOPOIETIC stem cell transplantation
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      – SubjectFull: LYMPHOBLASTIC leukemia
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      – SubjectFull: EVALUATION of medical care
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      – SubjectFull: MEDICAL cooperation
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      – SubjectFull: RESEARCH
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      – SubjectFull: DISEASE remission
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      – SubjectFull: RETROSPECTIVE studies
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      – SubjectFull: SYMPTOMS
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      – TitleFull: Acute Lymphoblastic Leukemia in Routine Practice: A Turkish Multicenter Study.
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