Feasibility of reduced‐intensity allogeneic stem cell transplantation with imatinib in children with philadelphia chromosome‐positive acute lymphoblastic leukemia

Yamada, K; Yasui, Masayoshi; Kondo, Osamu; Sato, Maho; Sawada, Akihisa; Kawa, Keisei; Inoue, Masami

doi:10.1002/pbc.24507

Cited by 4 publications

(1 citation statement)

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“…Finally, regarding methods to improve survival of Ph+ ALL patients, reduced intensity conditioning for transplant may be considered. A report on a small series of patients showed that non-myeloablative conditioning may be a valid option, with four out of five patients surviving disease-free [20]. Validity of reduced intensity conditioning becomes important when one considers the 5-year incidence of NRM of 17% in our study.…”

Section: Discussionmentioning

confidence: 83%

Outcome and prognostic factors of children with Philadelphia chromosome-positive acute lymphoblastic leukemia treated with imatinib followed by allogeneic hematopoietic cell transplantation in first remission

et al. 2019

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Background Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) is a subset of ALL with poor prognosis. Here, we analyzed the outcomes and prognostic factors of children with Ph+ ALL who received imatinib and chemotherapy followed by allogeneic hematopoietic cell transplantation (HCT) in first complete remission (CR). Methods Thirty-one Ph+ ALL patients (female 10) diagnosed from January 2005 to December 2016 were included in the study. All patients were treated with imatinib and chemotherapy before HCT. Bone marrow (BM) evaluations included real-time quantitative polymerase chain reaction (RQ-PCR) study of the BCR-ABL1 fusion transcript. All patients received HCT with total body irradiation (TBI)-based conditioning at a median of 6.4 (range, 4.2–47.1) months from diagnosis. Results Compared to values at diagnosis, the median decrement of RQ-PCR value post-consolidation, and prior to HCT was −3.7 Log and −4.8 Log, respectively. The 5-year event-free survival (EFS) and overall survival of the patients were 64.5±9.4% (20/31) and 75.0±8.3% (23/31) respectively. Events included relapse (N=5) and death in CR post-HCT (N=6). The 5-year incidence of molecular relapse was 30.9±9.1% (9/31). An RQ-PCR decrement of at least −4 Log post-consolidation significantly predicted lower incidence of molecular relapse: 7.7±7.7% for ≥−4 Log decrement, 50.0±13.8% for <−4 Log decrement ( P =0.027). Conclusion Decrement in RQ-PCR for the BCR-ABL1 transcript that was determined after consolidation was the only significant prognostic factor for incidence of molecular relapse. In the post-induction TKI initiation setting, steadfast imatinib treatment during consolidation may allow for optimum post-HCT outcomes.

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Section: Discussionmentioning

confidence: 83%

Outcome and prognostic factors of children with Philadelphia chromosome-positive acute lymphoblastic leukemia treated with imatinib followed by allogeneic hematopoietic cell transplantation in first remission

et al. 2019

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A Case of Childhood Blastic Phase Chronic Myeloid Leukemia With Minor BCR-ABL

Yamanaka

Shimizu

Sato

et al. 2019

Journal of Pediatric Hematology/Oncology

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Chronic myeloid leukemia (CML) is commonly associated with major BCR-ABL transcript. We present a child with blastic phase CML associated with minor BCR-ABL transcript without prior CML diagnosis. Diagnosis was achieved by fluorescence in situ hybridization of peripheral blood neutrophils, which identified 90% as BCR-ABL positive. The patient received chemotherapy with imatinib followed by dasatinib and underwent reduced-intensity hematopoietic allogeneic stem cell transplantation with prophylactic posttransplant dasatinib for 2 years and has remained in complete molecular remission. Our intensified treatment regimen was effective compared with previous studies on minor BCR-ABL CML describing inferior outcomes with tyrosine kinase inhibitor therapy.

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Feasibility of reduced‐intensity allogeneic stem cell transplantation with imatinib in children with philadelphia chromosome‐positive acute lymphoblastic leukemia

Cited by 4 publications

References 21 publications

Outcome and prognostic factors of children with Philadelphia chromosome-positive acute lymphoblastic leukemia treated with imatinib followed by allogeneic hematopoietic cell transplantation in first remission

Outcome and prognostic factors of children with Philadelphia chromosome-positive acute lymphoblastic leukemia treated with imatinib followed by allogeneic hematopoietic cell transplantation in first remission

Imatinib

A Case of Childhood Blastic Phase Chronic Myeloid Leukemia With Minor BCR-ABL

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