Open AccessCAG regimen for refractory or relapsed adult T‐cell acute lymphoblastic leukemia: A retrospective, multicenter, cohort study
Author(s) -
Qian JieJing,
Hu Xiaoxia,
Wang Ying,
Zhang Yi,
Du Juan,
Yang Min,
Tong Hongyan,
Qian WenBin,
Wei Juying,
Yu Wenjun,
Lou YinJun,
Mao Liping,
Tao Meng Hai,
You LiangShun,
Wang Libing,
Li Xia,
Huang Xin,
Cao LiHong,
Zhao JianZhi,
Yan Yan Xiao,
Chen YuBao,
Chen Yu,
Zhang SuJiang,
Jin Jie,
Hu Jiong,
Zhu HongHu
Publication year - 2020
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.3079
Subject(s) - regimen , medicine , aclarubicin , cytarabine , refractory (planetary science) , transplantation , salvage therapy , gastroenterology , surgery , chemotherapy , biology , astrobiology
Adult patients with relapsed or refractory T‐cell acute lymphoblastic leukemia (R/R‐T‐ALL) have extremely poor prognosis, representing an urgent unmet medical need. Finding an optimal salvage regimen to bridge transplantation is a priority. The CAG (cytarabine, aclarubicin, and G‐CSF) regimen was initially used by one group in China, showing unexpectedly promising results in 11 R/R‐T‐ALL patients. Here, we report the multicenter results of 41 patients who received the CAG regimen as salvage therapy. After one cycle of the CAG regimen, complete remission and partial remission were achieved in 33 (80.5%) and two (4.9%) patients, respectively. Failure to respond was observed in six patients (14.6%). Early T‐cell precursor (ETP) (n = 26) and non‐ETP (n = 15) patients had a similar CR rate (80.8% vs 80.0%, P = .95). Among 41 patients, allo‐HSCT was successfully performed in 27 (66%) patients (22 in CR and 5 in non‐CR). With a median follow‐up time of 12 months, the estimated 2‐year overall survival and event‐free survival were 68.8% (95% CI, 47.3%‐83.0%) and 56.5% (95% CI, 37.1%‐71.9%), respectively. The CAG regimen was well‐tolerated, and no early death occurred. Our multicenter results show that the CAG regimen is highly effective and safe, representing a novel choice for adult patients with R/R‐T‐ALL and providing a better bridge to transplantation.