Treatment of BCR-ABL Negative ALL in Adults According to MRD and Genetics
Treatment of BCR-ABL Negative ALL in Adults According to MRD and Genetics
After consolidation therapy adult patients (≥18 yr) with Ph-negative ALL will be treated with continuation chemotherapy or allogeneic hematopoietic stem cell transplantation (alloHSCT) according to both measurable residual disease (MRD) and results of genetic study performed at baseline.
Patients will be uniformly treated with four drug-induction: vincristine (VCR), prednisone (PDN), pegylated asparaginase (PegASP), daunorubicin (DNR).
Resistant patients will receive a second induction with fludarabine, Ara-C, G-Colony-Stimulating Factor (G-CSF) and idarubicin (FLAG-IDA).
Patients with adequate MRD clearance after induction will receive 3 blocks of early consolidation. If adequate MRD clearance and good genetic background, the patients will proceed to delayed intensification, reinduction and maintenance. The remaining patients will receive early or delayed alloHSCT.
Inclusion Criteria:
Exclusion Criteria:
jribera@iconcologia.net934978987
Badalona, Barcelona 08916, Spain
jribera@iconcologia.net934978987
Bellvitge, Spain
Lanzarote, Spain