ADULT ACUTE LYMPHOBLASTIC-LEUKEMIA - COMP ARATIVE-STUDY OF THE CLINICOBIOLOGICAL FEATURES AND RESPONSE TO TREATMENT BASED ON AGE IN A GROUPOF 41 PATIENTS

BACKGROUND: The aim of this study was to analyze the influence of age on the clinical and biological features as well as the results of trea tment in 41 adult patients with acute lymphoblastic leukemia (ALL). PA TIENTS AND METHODS: The patients diagnosed with ALL from January 1989 to October 1995 in a single center were studied. Two groups of patient s were analyzed based on age. The main clinical, hematologic and bioch emical parameters, morphologic subtype and immunologic phenotype and t he results of the cytogenetic study were analyzed. Likewise, the attai nment of complete remission (CR), its duration and overall survival (O S) were also studied. Comparison of the cited variables and the result s of treatment among the two groups of patients was performed. RESULTS : Group I was made of 19 (11 males, 8 females) patients greater than o r equal to 50 years of age (mean age 65 +/- 9 years). Group II include d 22 patients (11 males and 11 females) with a mean age of 28 +/- 11 y ears. Significant differences were only observed between the two group s in regard to the proportion of peripheral blood blasts (p < 0.02), s erum LDH values (p = 0.05) and the performance status at the time of d iagnosis (p < 0.00007). In the patients in group I cytogenetic alterat ions were more frequent (10/16 vs 4/20, p < 0.02), being mainly pseudo diploid. Complete remission was achieved in 7/16 patients in group I a nd in 17/22 in group II (p < 0.02). The median duration of CR was 34 a nd 18 months, respectively. The median OS was 7 months in group 1 and 15 months in group II with an estimated survival at 5 years of 0% in g roup I and 38% in group II (p < 0.05). CONCLUSIONS: Patients with acut e lymphoblastic leukemia over the age of 50 years have a worse general status and more cytogenetic alterations (particularly Structural) tha n younger adult patients, presenting a lower probability of achieving complete remission and a shorter survival.