Effect of Adults and Pediatric-inspired Schemes on Negative Measurable Residual Disease and Overall Survival in Adults with Acute Lymphoblastic Leukemia: A Retrospective Analysis from the Hematology Department at Hospital Regional de Alta Especialidad de Ixtapaluca, Mexico

Background: The treatment for acute lymphoblastic leukemia (ALL) is based upon combining chemotherapy, tyrosine kinase inhibitors, and bi-specific monoclonal antibodies. Screening throughout the measurable residual disease is the main tool to establish the prognosis and risk of relapse. Induction protocols include a combination of steroids, anthracyclines, vinca alkaloids, and, in the pediatric-inspired schemes, asparaginase. Material and Methods: A retrospective study included clinical records of patients with acute lymphoblastic leukemia who received treatment based on Hyper-CVAD (adult scheme) or CALGB 10403 (pediatric scheme) between 2018 and 2023. Results: A total of 460 clinical records of patients were collected. 50.2% were male. The average age was 34 years old. 20.7% (n=95) received the pediatric scheme, while 79.3% (n=365) received the adult scheme. Pediatric scheme patients presented a higher ratio of complete remissions (67.4%), while adult scheme (57.3%) (p=0.047). When comparing survival according to groups, pediatric scheme patients presented higher survival rates than adult patients (Log-Rank 0.000). Conclusions: The introduction of bearable and accessible schemes with the choice of outpatient administration is ideal for the health systems of Latin America. Along with the treatment selection, strict screening through a standardized technique remains the main prognosis factor for the treatment of adult acute lymphoblastic leukemia.