Treatment of Acute Lymphoblastic Leukemia (ALL) in Younger Adults
Treatment of Acute Lymphoblastic Leukemia (ALL) in Younger Adults
This study is a multicenter trial of treatment for young ALL patients. All ALL patients will
 receive the same steroid pre-phase in order to evaluate sensitivity or resistance. Then,
 patients will be included into 3 specific trials according to biological features
 (immunophenotype, cytogenetics, and molecular biology).

 Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL) 2005:

 -  T ALL or B ALL non Ph (N=810 patients planned).

 -  GRAALL 2005 R: B ALL non Ph CD20+ (N=220 patients planned).

 -  GRAAPH 2005: ALL Ph+ (N=270 patients planned)
GRAALL 2005: T ALL or B ALL non Ph

 Randomization between standard versus intensified cyclophosphamide administration during a
 4-drug, 4 week chemotherapy and late intensification.

 (N=810 patients planned)

 GRAALL 2005 R: B ALL non Ph CD20+

 Randomization between standard versus intensified cyclophosphamide administration during a
 4-drug, 4 week chemotherapy and late intensification.

 Randomization between Mabthera (rituximab) or no Mabthera during all induction and
 consolidation courses.(N=220 patients planned)

 Allogenic transplantation will be performed depending on unfavourable risk factors.

 GRAAPH 2005: ALL Ph

 Randomization between an imatinib-based induction and a chemotherapy + imatinib induction.
 (N=270 patients planned)

 Allogenic transplantation will be systematically performed in the presence of related or
 unrelated donors.

 Autologous transplantation could be performed in the absence of a donor in case of Molecular
 Residual Disease (MRD) ≤ 10-4.

 Consolidation therapy will be performed in the absence of a donor in case of MRD > 10-4.
Inclusion Criteria:

 -  18-59 years

 -  ALL newly diagnosed (blast < 20%)

 -  Central Nervous System (CNS) positive or negative

 -  Signed written informed consent

 -  For GRAAPH trial only: t(9;22) or BCR- ABL positive

 Exclusion Criteria:

 -  Lymphoblastic lymphoma

 -  ALL 3

 -  Chronic myeloid leukemia

 -  Severe organ condition