{"id":"https://openalex.org/W2531034485","doi":"https://doi.org/10.1182/blood.v120.21.4297.4297","title":"Adult ALL Patients Treated with Pediatric Inspired Trials Have Inacceptable Early Death but Better Relapse Free Survival Compared to Adult Trials: A Tunisian Single Center Experience","display_name":"Adult ALL Patients Treated with Pediatric Inspired Trials Have Inacceptable Early Death but Better Relapse Free Survival Compared to Adult Trials: A Tunisian Single Center Experience","publication_year":2012,"publication_date":"2012-11-16","ids":{"openalex":"https://openalex.org/W2531034485","doi":"https://doi.org/10.1182/blood.v120.21.4297.4297","mag":"2531034485"},"language":"en","primary_location":{"id":"doi:10.1182/blood.v120.21.4297.4297","doi":"https://doi.org/10.1182/blood.v120.21.4297.4297","is_oa":false,"landing_page_url":"https://doi.org/10.1182/blood.v120.21.4297.4297","pdf_url":null,"source":{"id":"https://openalex.org/S200071133","display_name":"Blood","issn_l":"0006-4971","issn":["0006-4971","1528-0020"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Blood","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5111302626","display_name":"Hend Ben Neji","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Hend Ben Neji","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5020118455","display_name":"Yosr Ben Abdennebi","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Yosr Ben Abdennebi","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5041885795","display_name":"Lamia Aissaou\u00ef","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Lamia Aissaoui","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5063236502","display_name":"Ramzi Jeddi","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Ramzi Jeddi","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5059261277","display_name":"Mohamed Zarrouk","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Mohamed Zarrouk","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113591590","display_name":"Ramzi Ben Amor","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Ramzi Ben amor","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110136170","display_name":"Karima Kacem","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Karima Kacem","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5033849310","display_name":"Raihane Ben Lakhal","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Raihane Ben Lakhal","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5081326880","display_name":"Zaher Belhadj Ali","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Zaher Belhadj Ali","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"middle","author":{"id":null,"display_name":"Hela Ben Abid","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Hela Ben Abid","raw_affiliation_strings":["Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hematology, Aziza Othmana University Hospital, Tunis, Tunisia,","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5019341062","display_name":"Balkis Meddeb","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Balkis Meddeb","raw_affiliation_strings":["Department of Haematology, Aziza Othmana University Hospital, Tunis, Tunisia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Haematology, Aziza Othmana University Hospital, Tunis, Tunisia","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5019341062","https://openalex.org/A5020118455","https://openalex.org/A5033849310","https://openalex.org/A5041885795","https://openalex.org/A5059261277","https://openalex.org/A5063236502","https://openalex.org/A5081326880","https://openalex.org/A5110136170","https://openalex.org/A5111302626","https://openalex.org/A5113591590"],"corresponding_institution_ids":[],"apc_list":{"value":5500,"currency":"USD","value_usd":5500},"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.33205594,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"120","issue":"21","first_page":"4297","last_page":"4297"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10950","display_name":"Acute Lymphoblastic Leukemia research","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10950","display_name":"Acute Lymphoblastic Leukemia research","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10309","display_name":"Acute Myeloid Leukemia Research","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11559","display_name":"Retinoids in leukemia and cellular processes","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/1312","display_name":"Molecular Biology"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/adult-acute-lymphoblastic-leukemia","display_name":"adult acute lymphoblastic leukemia","score":0.9919999837875366},{"id":"https://openalex.org/keywords/early-mortality","display_name":"early mortality","score":0.4519999921321869},{"id":"https://openalex.org/keywords/relapse-free-survival","display_name":"relapse-free survival","score":0.9380000233650208},{"id":"https://openalex.org/keywords/induction-mortality","display_name":"induction mortality","score":0.4390000104904175},{"id":"https://openalex.org/keywords/hyper-cvad","display_name":"hyper-CVAD","score":0.7149999737739563},{"id":"https://openalex.org/keywords/cns-relapse","display_name":"central nervous system relapse","score":0.5230000019073486},{"id":"https://openalex.org/keywords/cns-prophylaxis","display_name":"CNS prophylaxis","score":0.6370000243186951},{"id":"https://openalex.org/keywords/allogeneic-stem-cell-transplantation","display_name":"allogeneic stem cell transplantation","score":0.6570000052452087},{"id":"https://openalex.org/keywords/immunophenotype","display_name":"immunophenotype","score":0.5659999847412109},{"id":"https://openalex.org/keywords/developing-countries","display_name":"developing countries","score":0.5360000133514404}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8667570352554321},{"id":"https://openalex.org/C194409129","wikidata":"https://www.wikidata.org/wiki/Q103824","display_name":"Hematology","level":2,"score":0.5086603760719299},{"id":"https://openalex.org/C2781413609","wikidata":"https://www.wikidata.org/wiki/Q7308373","display_name":"Regimen","level":2,"score":0.5086385011672974},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.43410444259643555},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.41936230659484863},{"id":"https://openalex.org/C2780073493","wikidata":"https://www.wikidata.org/wiki/Q7523837","display_name":"Single Center","level":2,"score":0.4178241789340973},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.35095757246017456}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1182/blood.v120.21.4297.4297","doi":"https://doi.org/10.1182/blood.v120.21.4297.4297","is_oa":false,"landing_page_url":"https://doi.org/10.1182/blood.v120.21.4297.4297","pdf_url":null,"source":{"id":"https://openalex.org/S200071133","display_name":"Blood","issn_l":"0006-4971","issn":["0006-4971","1528-0020"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Blood","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4385667032","https://openalex.org/W2979733804","https://openalex.org/W2056710396","https://openalex.org/W4283716842","https://openalex.org/W2588480636","https://openalex.org/W2951042525","https://openalex.org/W2979675959","https://openalex.org/W2588708515","https://openalex.org/W2601668405","https://openalex.org/W2560147268"],"abstract_inverted_index":{"Abstract":[0,1],"4297":[2],"Background:":[3],"In":[4],"Tunisia":[5,455],"children":[6],"with":[7,20,130,154,220,284,383,401,414,463],"acute":[8],"lymphoblastic":[9],"leukemia":[10,261],"(ALL)":[11],"are":[12,412],"treated":[13,129,153,219],"according":[14],"to":[15,67,105,204,225,398,423,432,493,503,516],"the":[16,44,50,68,75,79,86,101,107,115,135,263,367,392,444,506],"EORTC":[17,190],"58951":[18],"protocol":[19,157,202],"complete":[21],"remission":[22,310,420],"rate":[23,46,207,311,435],"(CR)":[24],"of":[25,36,43,47,53,65,88,100,109,117,138,143,208,211,255,293,436,443,447,451,485,497,514],"84%":[26],"and":[27,63,121,148,163,214,227,247,253,262,327,331,356,407,459,482,487,508],"long-term":[28],"survivals":[29],"reaching":[30],"80%":[31],"at":[32,290],"5":[33,330],"years.":[34],"Survivals":[35],"adult":[37,89,118,125,452,469],"ALL":[38,90,126,249,453,470],"remain":[39],"disappointing":[40],"mainly":[41,441],"because":[42,442],"high":[45,434],"early":[48,320,416],"deaths,":[49],"limited":[51],"number":[52,446,496],"allografted":[54],"patients":[55,93,127,151,175,188,216,282,294,301,317,440,498],"performed":[56],"only":[57],"for":[58,92,468],"those":[59],"aged":[60],"<":[61],"40y,":[62],"lack":[64],"access":[66],"international":[69],"bone":[70,357],"marrow":[71,358],"donors":[72],"registry.":[73],"Are":[74],"improvements":[76],"made":[77],"in":[78,82,85,95,114,134,250,268,329,438,454,473],"last":[80],"decades":[81],"developed":[83],"countries":[84],"treatment":[87],"transposable":[91],"diagnosed":[94],"developing":[96],"countries?":[97],"The":[98,449],"aim":[99],"present":[102],"study":[103,369],"is":[104,235,426,430,456,471],"report":[106],"experience":[108],"a":[110,305,380,396,433,489,494],"Tunisian":[111,155],"hematology":[112,136],"center":[113],"management":[116,484],"ALL.":[119,298],"Patients":[120],"methods:":[122],"Fifty":[123],"one":[124,269],"were":[128,152,217],"three":[131,393],"consecutive":[132],"trials":[133,394,404],"department":[137],"Aziza":[139],"Othmana":[140],"university":[141],"hospital":[142],"Tunis":[144],"between":[145,161,391],"January":[146],"2005":[147,162],"July":[149],"2011.18":[150],"LALA03":[156,406],"(pediatric":[158],"\u2013inspired":[159],"induction)":[160],"2007:":[164],"BFM-like":[165],"HR":[166,174],"induction":[167,209,313,323,478],"(PND":[168],"60mg/m2x22d,":[169],"VCRx4,":[170],"DNR":[171],"30mg/m2x4,":[172],"ASPx8).":[173],"receive":[176,189],"6":[177],"consolidations":[178,192],"blocs":[179],"(GRAALL03":[180],"blocs)":[181],"+":[182],"CNS":[183],"RT+":[184],"maintenance":[185],"therapy.":[186,200],"SR":[187],"AR2":[191],"(IB,":[193],"interval":[194],"therapy,":[195],"IIAIIB)":[196],"+CNS":[197],"RT":[198],"+maintenance":[199],"This":[201],"led":[203],"an":[205,501],"inacceptable":[206],"death":[210,321,417,477],"38.8%.":[212],"24":[213],"9":[215],"respectively":[218,251],"Hyper-CVAD":[221,425],"regimen":[222],"from":[223,304,324],"2008":[224],"2010":[226],"GRAALL05":[228],"since":[229],"2010.":[230],"Results:":[231],"Male/female":[232],"ratio":[233],"was":[234,239,265,275,314,339,345,377,387],"2.6.":[236],"Median":[237,271,335],"age":[238,350],"37.5":[240],"years":[241,343,354],"(21\u201359).":[242],"Immunophenotyping":[243],"revealed":[244],"B-cell":[245],"precursor":[246],"T-lineage":[248],"60%":[252],"35%":[254],"patients.":[256],"1":[257],"patient":[258],"had":[259,302,319,361],"biphenotypic":[260],"immunophenotype":[264],"not":[266],"precised":[267],"case.":[270],"baseline":[272],"WBC":[273],"count":[274],"18.2":[276],"\u00d7":[277],"109/L":[278],"(0.3\u2013265":[279],"\u00d7109/L).":[280],"Three":[281],"presented":[283],"central":[285],"nervous":[286],"system":[287],"(CNS)":[288],"disease":[289],"diagnosis.":[291],"21.5%":[292],"have":[295],"Philadelphia":[296],"positive":[297,362],"Only":[299],"14":[300],"SCT":[303],"matched":[306],"sibling":[307],"donor.":[308],"Complete":[309],"after":[312],"74.5%.":[315],"Eight":[316],"(15.6%)":[318],"during":[322],"septic":[325],"shock":[326],"pneumonia":[328],"3":[332,342,371],"cases":[333],"respectively.":[334],"overall":[336],"survival":[337,375],"(OS)":[338],"18":[340],"months.":[341],"OS":[344],"30%.":[346],"By":[347],"univariate":[348],"analysis,":[349],"less":[351],"than":[352],"32":[353],"(p=0.01)":[355],"transplantation":[359],"(p=0.04)":[360],"impact":[363],"on":[364,505],"OS.":[365,509],"For":[366],"whole":[368],"population":[370],"year":[372],"relapse":[373,437],"free":[374],"(RFS)":[376],"20%.":[378],"Despite":[379],"lower":[381],"RFS":[382,507],"Hyper":[384],"CVAD":[385],"there":[386],"no":[388],"significant":[389],"difference":[390],"but":[395,418,429],"trend":[397],"better":[399,483],"outcome":[400,450],"pediatric":[402],"inspired":[403],"i.e.":[405],"GRAALL05.":[408],"Conclusion:":[409],"Pediatric-inspired":[410],"protocols":[411],"associated":[413,431],"increased":[415],"prolonged":[419],"duration":[421],"compared":[422],"Hyper-CVAD.":[424],"well":[427],"tolerated":[428],"our":[439,474],"small":[445],"SCT.":[448],"still":[457],"unsatisfactory":[458],"can":[460],"be":[461,500],"improved":[462],"pediatric-like":[464],"regimens.":[465],"Effective":[466],"therapy":[467],"feasible":[472],"country.":[475],"Controlling":[476],"by":[479],"supportive":[480],"measures":[481],"myelosuppression":[486],"offering":[488],"stem":[490],"cell":[491],"transplant":[492],"greater":[495],"could":[499],"option":[502],"improve":[504],"Disclosures:":[510],"No":[511],"relevant":[512],"conflicts":[513],"interest":[515],"declare.":[517]},"counts_by_year":[],"updated_date":"2026-09-22T06:50:58.402377","created_date":"2016-10-21T00:00:00"}