From ASH Meeting on Hematologic Malignancies: Treating a Young Patient With Newly Diagnosed ALL

Anjali Advani, MD
Staff Physician in the Department of Hematologic Oncology and Blood Disorders and Director of the Inpatient Leukemia Program at the Taussig Cancer Institute at Cleveland Clinic

During their presentations, MHM speakers will be asking the audience how they would respond to patient cases. Audience members will vote live at the meeting via an audience response system, but we want to know what you would do.

CLINICAL DILEMMA

A 20-year-old man presents with a two-week history of fatigue, bleeding, and low-grade fevers.

His lab results showed the following: white blood cells 2×109/L, hemoglobin 6.0 g/dL, and platelets 20×109/L. A bone marrow aspirate and biopsy show 70 percent blasts and was positive for CD10, CD19, TdT, and CD34 (but negative for CD20), consistent with pre–B-cell ALL.

How would you treat this patient?

  1. A pediatric-based regimen (i.e., the C10403 protocol [vincristine, daunorubicin, pegaspargase, prednisone])
  2. Hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate, cytarabine)
  3. CALGB 19802 regimen (cyclophosphamide, daunorubicin, vincristine, prednisone, L-asparaginase)

Let us know how you would respond at ashclinicalnews@hematology.org!

Here’s how audience members responded:

  • A pediatric-based regimen (i.e., the C10403 protocol)
  • Hyper-CVAD
  • The CALGB 19802 regimen

Disclaimer: ASH does not recommend or endorse any specific tests, physicians, products, procedures, or opinions, and disclaims any representation, warranty, or guaranty as to the same. Reliance on any information provided in this article is solely at your own risk.

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