TY - JOUR
T1 - Long-term follow-up of allogeneic hematopoietic stem cell transplantation for patients with philadelphia chromosome-positive acute lymphoblastic leukemia
T2 - Impact of tyrosine kinase inhibitors on treatment outcomes
AU - Kebriaei, Partow
AU - Saliba, Rima
AU - Rondon, Gabriela
AU - Chiattone, Alexandre
AU - Luthra, Rajyalakshmi
AU - Anderlini, Paolo
AU - Andersson, Borje
AU - Shpall, Elizabeth
AU - Popat, Uday
AU - Jones, Roy
AU - Worth, Laura
AU - Ravandi, Farhad
AU - Thomas, Deborah
AU - O'Brien, Susan
AU - Kantarjian, Hagop
AU - de Lima, Marcos
AU - Giralt, Sergio
AU - Champlin, Richard
PY - 2012/4
Y1 - 2012/4
N2 - The introduction of tyrosine kinase inhibitors (TKI) has revolutionized therapy for patients with acute lymphoblastic leukemia (ALL) who have the Philadelphia (Ph) chromosome. A retrospective analysis was conducted on 102 adults and 11 children who received a first-matched related (n = 60), matched unrelated (n = 40), mismatched cord blood (n = 12), or haploidentical (n = 1) allogeneic hematopoietic stem cell transplantation (HSCT) for Ph-positive (Ph+) ALL in first complete remission (n = 71), second complete remission (n = 11), or with active disease (n = 31) between 1990 and 2009. Sixty-seven patients received TKI with upfront ALL therapy, and 32 patients received TKI maintenance following HSCT. With median follow-up of 5 years among survivors (range: 1.1-20.4 years), overall survival (OS) was significantly better for patients transplanted in first remission compared with HSCT in advanced disease: 43% versus 16%,. P = 002. Disease stage and age at time of HSCT, the development of acute graft-versus-host disease (aGVHD), and decade of HSCT were found to significantly impact OS, progression-free survival (PFS), and nonrelapse mortality (NRM) in multivariate analyses. Allogeneic HSCT provides durable remission for patients with Ph+ ALL in first remission. Neither TKI use pre- nor post-HSCT were found to significantly impact transplant outcomes in univariate and multivariate analyses.
AB - The introduction of tyrosine kinase inhibitors (TKI) has revolutionized therapy for patients with acute lymphoblastic leukemia (ALL) who have the Philadelphia (Ph) chromosome. A retrospective analysis was conducted on 102 adults and 11 children who received a first-matched related (n = 60), matched unrelated (n = 40), mismatched cord blood (n = 12), or haploidentical (n = 1) allogeneic hematopoietic stem cell transplantation (HSCT) for Ph-positive (Ph+) ALL in first complete remission (n = 71), second complete remission (n = 11), or with active disease (n = 31) between 1990 and 2009. Sixty-seven patients received TKI with upfront ALL therapy, and 32 patients received TKI maintenance following HSCT. With median follow-up of 5 years among survivors (range: 1.1-20.4 years), overall survival (OS) was significantly better for patients transplanted in first remission compared with HSCT in advanced disease: 43% versus 16%,. P = 002. Disease stage and age at time of HSCT, the development of acute graft-versus-host disease (aGVHD), and decade of HSCT were found to significantly impact OS, progression-free survival (PFS), and nonrelapse mortality (NRM) in multivariate analyses. Allogeneic HSCT provides durable remission for patients with Ph+ ALL in first remission. Neither TKI use pre- nor post-HSCT were found to significantly impact transplant outcomes in univariate and multivariate analyses.
KW - Allogeneic hematopoietic stem cell transplantation
KW - Philadelphia chromosome-positive acute lymphoblastic leukemia
KW - Tyrosine kinase inhibitor
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U2 - 10.1016/j.bbmt.2011.08.011
DO - 10.1016/j.bbmt.2011.08.011
M3 - Article
C2 - 21867666
AN - SCOPUS:84858075678
SN - 1083-8791
VL - 18
SP - 584
EP - 592
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 4
ER -