{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:31:12Z","timestamp":1792621872154,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,3,13]],"date-time":"2012-03-13T00:00:00Z","timestamp":1331596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Although the incidence rate of acute lymphoblastic leukaemia (<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>) is slightly higher in older than in younger adults, response rates to induction chemotherapy and survival rates are poorer. The contribution of disease\u2010related <jats:italic>versus<\/jats:italic> treatment\u2010related factors remains unclear. We analysed 100 older patients (aged 55\u201365\u00a0years) treated on the <jats:styled-content style=\"fixed-case\">UKALLXII<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">ECOG<\/jats:styled-content>2993 trial compared with 1814 younger patients (aged 14\u201354\u00a0years). Baseline characteristics, induction chemotherapy course, infections, drug reductions and survival outcomes were compared. There were more Philadelphia\u2010positive (<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>h+) patients in the older group (28% vs. 17%, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0=\u00a00\u00b702), and a trend towards higher combined cytogenetic risk score (46% vs. 35%, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0=\u00a00\u00b707). The complete remission rate in older patients was worse (73% vs. 93%, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0&lt;\u00a00\u00b70001) as was 5\u2010year overall survival (21% vs. 41%, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0&lt;\u00a00\u00b70001) and event\u2010free survival (<jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content>) (19% vs. 37%, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0&lt;\u00a00\u00b70001). Older patients had more infections during induction (81% vs. 70%, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0=\u00a00\u00b705), and drug reductions (46% vs. 28%, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u00a0=\u00a00\u00b70009). Among older patients, <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>h+ and cytogenetic risk category as well as infection during induction predicted for worse <jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content>. Poorer outcomes in these patients are partly due to cytogenetic risk, but there is significant morbidity and mortality during induction chemotherapy with frequent delays and drug reductions. New approaches, including better risk stratification and use of targeted therapies, could improve treatment for these patients.<\/jats:p>","DOI":"10.1111\/j.1365-2141.2012.09095.x","type":"journal-article","created":{"date-parts":[[2012,3,13]],"date-time":"2012-03-13T07:22:38Z","timestamp":1331623358000},"page":"463-471","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":178,"title":["Outcomes in older adults with acute lymphoblastic leukaemia (<scp>ALL<\/scp>): results from the international <scp>MRC UKALL XII<\/scp>\/<scp>ECOG<\/scp>2993 trial"],"prefix":"10.1111","volume":"157","author":[{"given":"Jonathan I.","family":"Sive","sequence":"first","affiliation":[{"name":"University College London Hospital London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Buck","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Fielding","sequence":"additional","affiliation":[{"name":"Royal Free Hospital University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillard M.","family":"Lazarus","sequence":"additional","affiliation":[{"name":"University Hospitals Case Medical Center Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Litzow","sequence":"additional","affiliation":[{"name":"Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selina","family":"Luger","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David I.","family":"Marks","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol NHS Foundation Trust Bristol"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"McMillan","sequence":"additional","affiliation":[{"name":"Nottingham City Hospital Nottingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony V.","family":"Moorman","sequence":"additional","affiliation":[{"name":"Northern Institute for Cancer Research Newcastle University Newcastle UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M.","family":"Richards","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob M.","family":"Rowe","sequence":"additional","affiliation":[{"name":"Rambam Medical Centre Technion Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin S.","family":"Tallman","sequence":"additional","affiliation":[{"name":"Memorial Sloan\u2010Kettering Cancer Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony H.","family":"Goldstone","sequence":"additional","affiliation":[{"name":"University College London Hospital London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,3,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V99.3.863"},{"key":"e_1_2_8_3_1","first-page":"528","volume-title":"American Society of Clinical Oncology Educational Book","author":"Appelbaum F.R.","year":"2005"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-11-056754"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1182\/blood.V116.21.169.169","article-title":"Imatinib significantly enhances long\u2010term outcomes in philadelphia positive acute lymphoblastic leukaemia; 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