Adolescent and young adult (AYA) patients with Philadelphia chromosome-negative (Ph-negative) acute lymphoblastic leukemia (ALL) showed differences from adults in biological characteristics and clinical outcomes in a recent study. Study findings were presented in a poster at the SOHO 2023 Annual Meeting by Olga Aleshina, MD, PhD, of the National Medical Research Center for Hematology in Moscow, Russian Federation, and colleagues.

Dr Aleshina and colleagues had an aim of evaluating treatment outcomes for AYA and adults treated according to a nonintensive, noninterruptive adult treatment strategy ( Identifiers: NCT01193933 and NCT03462095 for RALL-2009 and RALL-2016 trials, respectively). In this study, patients of 15 to 39 years of age were considered AYAs, while patients 40 to 55 years of age were categorized as adults.

The analysis included a total of 642 patients with Ph-negative ALL who were 15 to 55 years old. Among these patients, 505 were considered AYAs and 137 were considered adults.

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The researchers identified some differences in characteristics between the AYA and adult patient groups. For gender, in the AYA group 62% of patients were male and 38% were female, whereas in the adult group 48% were male, with 52% being female. These percentages reflected a statistically significant difference across these age groups (P =.0042).

ALL was considered to be of B-cell type in 55% of the AYA group, compared with 70% of the adult group; of T-cell type in 42% and 26%, respectively; and of mixed phenotype in 3% and 4%, respectively (P =.0077 overall). Early T-cell precursor ALL was found in 8% of the AYA group, compared with 0% of the adult group (P =.0218).

Central nervous system involvement was found in 12% of patients in each group (P =.8837). Lymphoblastic lymphoma was also found at similar rates between the groups, occurring in 8% of the AYA group and 5% of the adult group (P =.3534).

Complete remission was seen in 88% of AYA patients, which was similar to the rate in adult patients (85%; P =.0848). However, early mortality occurred in 6% of AYA patients, compared with 13% among adult patients, which was a statistically significant difference (P =.0197).

Rates of 5-year overall survival (OS) and 5-year disease-free survival (DFS) also differed by age. The 5-year OS rates were 64% in AYA patients and 55% in adults (P =.0286), and 5-year DFS rates were 65% in AYA patients and 53% in adult patients (P =.036).

Dr Aleshina and colleagues considered the findings for AYA patients treated using the RALL protocol to be comparable to those seen with AYA patients treated with a pediatric protocol from the EUROCARE-5 trial. AYA and adult patients also showed biological characteristics and in clinical outcomes in this study.


Aleshina O, Kotova E, Galtseva I, et al. Ph‑negative acute lymphoblastic leukemia (ALL) in adolescent and young adults: long‑term outcomes after treatment according to the adult strategy RALL protocol. Presented at the Eleventh Annual Meeting of the Society of Hematologic Oncology (SOHO); September 6-9, 2023; Abstract ALL-329.