Clinician Concepts of Cure in Adult Relapsed and Refractory Philadelphia-Negative B Cell Precursor Acute Lymphoblastic Leukemia: A Delphi Study

Springer Science and Business Media LLC
Publication Type:
Journal Article
Advances in Therapy, 2019, 36 (4), pp. 870 - 879
Issue Date:
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Introduction Despite the poor prognosis for adults with relapsed or refractory (RR) Philadelphia chromosome (Ph)-negative B cell precursor acute lymphoblastic leukemia (ALL), long-term survival is possible and may even be considered as “cure”. Methods This study used a Delphi panel approach to explore concepts of cure in RR Ph-negative B cell precursor ALL. Ten European experts in this disease area participated in a survey and face-to-face panel meeting. Results Findings showed that clinicians conceptualize “cure” as a combination of three broad treatment outcomes that vary depending on the treatment stage: complete remission early in treatment (1–3 months) indicates initial success; eradicating cancer cells (minimal residual disease negative status) consolidates the early clinical response; leukemia-free survival is required in the long term. Conclusions Although such terminology remains contested, clinicians would begin considering “cure” as early as 2 years provided the patient is off therapy, with most considering the term applicable by the third year.
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