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Here 229 relapsing Ph\u2212 ALL younger adults (18\u201363 years) treated within the Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL)-2003\/-2005 trials were considered. Salvage regimens consisted of potentially curative therapies in 194 cases, low-intensity therapies in 21, allogeneic stem cell transplant (allo-SCT) in 6 and best supportive care in 8. Overall, 77 patients received allo-SCT after relapse. The median follow-up was 3.1 years. A second complete remission (CR2) was achieved in 121 patients (53%). In multivariate analysis, only younger age &lt;45 years (<jats:italic>P<\/jats:italic>=0.008) and CR1 duration \u2a7e18 months (<jats:italic>P<\/jats:italic>=0.009) predicted CR2. Overall survival (OS) at 2 and 5 years was 19.3% (14\u201324%) and 13.3% (8\u201318%), respectively. In CR2 patients, disease-free survival (DFS) at 2 and 5 years was 29.0% (21\u201338%) and 25% (17\u201333%). In multivariate analysis, CR1 duration \u2a7e18 months and allo-SCT after relapse were associated with longer DFS (<jats:italic>P<\/jats:italic>&lt;0.009 and<jats:italic>P<\/jats:italic>=0.004, respectively) and longer OS (<jats:italic>P<\/jats:italic>=0.004 and<jats:italic>P<\/jats:italic>&lt;0.0001, respectively). In conclusion, although younger adults relapsing after pediatric-inspired ALL therapies retain a poor outcome, some of them may be cured if CR1 duration \u2a7e18 months and if allo-SCT can be performed in CR2. New therapies are definitely needed for these patients.<\/jats:p>","DOI":"10.1038\/bcj.2016.111","type":"journal-article","created":{"date-parts":[[2016,12,9]],"date-time":"2016-12-09T14:32:44Z","timestamp":1481293964000},"page":"e504-e504","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Acute lymphoblastic leukemia relapsing after first-line pediatric-inspired therapy: a retrospective GRAALL study"],"prefix":"10.1038","volume":"6","author":[{"given":"A","family":"Desjonqu\u00e8res","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Chevallier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Huguet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Leguay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Bernard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J-O","family":"Bay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Tavernier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Charbonnier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Isnard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Hunault","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Turlure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Renaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J-N","family":"Basti\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Himberlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Lepretre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Lioure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Lh\u00e9ritier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Asnafi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Beldjord","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Lafage-Pochitaloff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M C","family":"B\u00e9n\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Ifrah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Dombret","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the French Group for Research in Adult ALL (GRAALL)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2016,12,9]]},"reference":[{"key":"BFbcj2016111_CR1","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1002\/(SICI)1097-0142(19991001)86:7<1216::AID-CNCR17>3.0.CO;2-O","volume":"86","author":"DA Thomas","year":"1999","unstructured":"Thomas DA, Kantarjian H, Smith TL, Koller C, Cortes J, O'Brien S et al. 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