Abstract

Hyper-CVAD Protocol versus UKALL Protocol and the Minimal Residual Disease Status in Adult Acute Lymphoblastic Leukemia Patients

Author(s):Ahmed Mjali*, Bassam Francis Matti, Yassmin Ali Abdul Kareem, Dhulfiqar Azeez Hasan, Anmar Alharganee, Alaa Fadhil Alwan, Aladdin Sahham Naji, Tareq Abdullah Saleh, Amer Shareef Alhachmi, Ibrahim Khalil Al Shemmari, Haider Hasan Jaleel Al- Shammari, Talib Hussein Kamoona, Nareen Tawfeeq Abbas, Saja Khudhair Abbas and Ahmed Ibrahim Shukr

Introduction: In Iraq acute lymphoblastic leukemia (ALL) represents the most common hematological malignancy contributing 41% of all leukemia cases. Hyper-CVAD protocol and UKALL protocol are commonly used in ALL treatment. In this study, we tried to assess minimal residual disease (MRD) post induction therapy for both hyperCVAD protocol and UKALL protocol by using 8 colors flow cytometry.

Material and Method: Data collected retrospectively from 85 adult patients with acute lymphoblastic leukemia (≥ 14 years old) received either hyper-CVAD or UKALL chemotherapy protocol, with MRD level results post induction therapy of each protocol therapy, from January 2017 till October 2019. Fifty patients (58.82%) with B-ALL, while T-ALL were 35 patients (41.18%). Patients treated with hyper-CVAD protocol were 52 patients (61.18%) while 33 patients (38.82%) were treated with UKALL protocol.

Results: Patients with de novo ALL of Philadelphia chromosome negative, male to female ratio 2:1 and the mean age was 23 years. Thirty seven patients (43.53%) achieved MRD negative. Of these MRD negative patients, 14 patients (37.84%) were post UKALL while 23 patients (62.16%) were post hyper-CVAD protocol with (p=0.9). Conclusion: Both hyper-CVAD and UKALL protocol therapy in adult ALL have a good efficacy without significant difference in achieving MRD negativity.

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