Abstract
BACKGROUND: BFM-95 protocol is among the common regimens used to treat adolescent and young adult (AYA) acute lymphoblastic leukaemia. Five-year survival in AYA patients with acute lymphoblastic leukaemia is inferior when compared to children. OBJECTIVE: To study treatment outcomes in adolescent and young adult patients with acute lymphoblastic leukaemia on BFM 95 protocol. MATERIAL AND METHODS: We retrospectively analysed the available data of 75 patients diagnosed with acute lymphoblastic leukaemia in the AYA age group who received treatment as per BFM-95 protocol from 2016 to 2020 in the clinical hematology department in a tertiary health care centre. RESULTS: Among 75 patients, 56 were male and 19 were female. High-risk patients were 15 (20%), 3 due to poor prednisolone response and 12 due to high-risk cytogenetics. Most of the patients were CNS-1 and three patients were of CNS-3. Eight (10.6%) patients did not complete induction treatment. The median duration of induction phase A was 40 days (range 35-45 days). The most common complication during induction phase A treatment was febrile neutropenia which was seen in 21 patients (28%), followed by transaminitis in 12 patients (21.1%). The median duration of follow-up was 2 years (range 8 months-5 years). Five (6%) patients' bone marrow were not in remission after induction-A. Relapse occurred in 23 patients (30.6%), with the highest incidence observed during the maintenance phase of treatment. Thirty-three (44%) patients completed maintenance and were still on follow-up. Twenty-three (30.7%) patients relapsed while six patients were lost to follow-up during maintenance. At a median follow-up of 2 years, disease-free survival was (44%). CONCLUSION: This study on AYA patients with acute lymphoblastic leukaemia/lymphoma using a pediatric protocol in a resource-limited setting observed suboptimal survival rates, which may be attributed to the retrospective design, significant data gaps and a small patient cohort with limited follow-up.