Acute Lymphoblastic Leukemia in Adult Patients: Single Egyptian Center, Six Years Clinical Practice Review

Although ALL is a very rare malignancy in adultsit is considered a devastating disease with long-term survival approaching around 30-40%. Proper understanding of the disease biology is the key in ALL management of patients, allowing individualized therapy protocols, as no case is typically like the other, and paving the way to targeted therapy and novel drugs. This is a retrospective study that was performed on 42 patients with newly diagnosed with ALL between January 2015 and December 2020 and were treated with different protocols (all have the same backbone but with different intensity and scheduling) in Kasr Al-Ainy Centre of Clinical Oncology and Nuclear Medicine (NEMROCK). A total of 35 patients diagnosed with ALL were eligible for inclusion in our final analysis. Overall Survival (OS) was 14.4 (95% CI 11.5-17.3) months. It was significantly affected by achieving CR after 1^st induction or not, with the median OS for those who achieved CR was 17.9 versus 5.3 months for those who were refractory with a p-value of 0.02. Initial TLC in patients with B-cell ALL significantly affected the OS with longer OS in those who presented with TLC <30,000, with a p-value of 0.03. Disease-free survival (DFS) was 13.3 months; it was significantly affected by achieving CR after 1^st induction, with p-values of 0.005. Personalized therapy with risk stratification before treatment initiation and during treatment is an important approach, especially MRD testing, which is a standard of care now in managing all.