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Adult ALL: treatment outcome and prognostic factors in an Indian population using a modified German ALL (GMALL) protocol

Leukemia volume 21, pages 2230–2233 (2007)Cite this article

Treatment outcome in adult acute lymphoblastic leukemia (ALL) has shown little improvement over the years with complete remission (CR) rates of 80–85% and leukemia-free survival of 30–40%.1, 2, 3 The results of treatment have significantly improved in T-cell and mature B-cell ALL, without much change in B-precursor ALL.4 Attempts to improve outcome include high-dose intensification, stem cell transplantation and risk-adapted therapy based on identified prognostic markers or minimal residual disease. However, in developing countries where state funding for expensive health-care interventions is lacking, it is important that treatment modifications should be cost effective.5 This is a retrospective analysis of the outcome of 210 adult patients with ALL (⩾15 years) treated with a modified German ALL (GMALL) protocol from 1994 to 2003. The aim of this study was to identify biologic and clinical prognostic markers for adult ALL in the Indian population and compare this with Caucasian data.

The diagnosis of ALL was based on morphological evaluation of May Grunwald Giemsa-stained smears of bone marrow and confirmed by cytochemistry and immunophenotypic analysis. Central nervous system (CNS) involvement was diagnosed if more than 5 cells per μl were present in a nontraumatic cerebro spinal fluid (CSF) at diagnosis and if lymphoblasts were identified on cytospin. Karyotypic analysis was not carried out systematically in this cohort of patients.

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Authors and Affiliations

  1. Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India

    A Bajel, B George, V Mathews, A Viswabandya, M L Kavitha, A Srivastava & M Chandy

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  1. A Bajel
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  2. B George
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  3. V Mathews
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  4. A Viswabandya
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  5. M L Kavitha
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  6. A Srivastava
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  7. M Chandy
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Correspondence to M Chandy.

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Bajel, A., George, B., Mathews, V. et al. Adult ALL: treatment outcome and prognostic factors in an Indian population using a modified German ALL (GMALL) protocol. Leukemia 21, 2230–2233 (2007). https://doi.org/10.1038/sj.leu.2404785

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