Tyrosine kinase inhibitors improve long-term outcome of allogeneic hematopoietic stem cell transplantation for adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia

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Brissot , E , Labopin , M , Beckers , M M , Socie , G , Rambaldi , A , Volin , L , Finke , J , Lenhoff , S , Kroeger , N , Ossenkoppele , G J , Craddock , C F , Yakoub-Agha , I , Gurman , G , Russell , N H , Aljurf , M , Potter , M N , Nagler , A , Ottmann , O , Cornelissen , J J , Esteve , J & Mohty , M 2015 , ' Tyrosine kinase inhibitors improve long-term outcome of allogeneic hematopoietic stem cell transplantation for adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia ' , Haematologica , vol. 100 , no. 3 , pp. 392-399 . https://doi.org/10.3324/haematol.2014.116954

Title: Tyrosine kinase inhibitors improve long-term outcome of allogeneic hematopoietic stem cell transplantation for adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia
Author: Brissot, Eolia; Labopin, Myriam; Beckers, Marielle M.; Socie, Gerard; Rambaldi, Alessandro; Volin, Liisa; Finke, Juergen; Lenhoff, Stig; Kroeger, Nicolaus; Ossenkoppele, Gert J.; Craddock, Charles F.; Yakoub-Agha, Ibrahim; Gurman, Gunhan; Russell, Nigel H.; Aljurf, Mahmoud; Potter, Michael N.; Nagler, Armon; Ottmann, Oliver; Cornelissen, Jan J.; Esteve, Jordi; Mohty, Mohamad
Other contributor: University of Helsinki, Department of Medicine


Date: 2015-03
Language: eng
Number of pages: 8
Belongs to series: Haematologica
ISSN: 0390-6078
DOI: https://doi.org/10.3324/haematol.2014.116954
URI: http://hdl.handle.net/10138/162087
Abstract: This study aimed to determine the impact of tyrosine kinase inhibitors given pre- and post- allogeneic stem cell transplantation on long- term outcome of patients allografted for Philadelphia chromosome- positive acute lymphoblastic leukemia. This retrospective analysis from the EBMT Acute Leukemia Working Party included 473 de novo Philadelphia chromosome- positive acute lymphoblastic leukemia patients in first complete remission who underwent an allogeneic stem cell transplantation using a human leukocyte antigen- identical sibling or human leukocyte antigen- matched unrelated donor between 2000 and 2010. Three hundred and ninety patients received tyrosine kinase inhibitors before transplant, 329 at induction and 274 at consolidation. Kaplan- Meier estimates of leukemia- free survival, overall survival, cumulative incidences of relapse incidence, and non- relapse mortality at five years were 38%, 46%, 36% and 26%, respectively. In multivariate analysis, tyrosine- kinase inhibitors given before allogeneic stem cell transplantation was associated with a better overall survival ( HR= 0.68; P= 0.04) and was associated with lower relapse incidence ( HR= 0.5; P= 0.01). In the post- transplant period, multivariate analysis identified prophylactic tyrosine- kinase inhibitor administration to be a significant factor for improved leukemiafree survival ( HR= 0.44; P= 0.002) and overall survival ( HR= 0.42; P= 0.004), and a lower relapse incidence ( HR= 0.40; P= 0.01). Over the past decade, administration of tyrosine kinase inhibitors before allogeneic stem cell transplantation has significantly improved the long- term allogeneic stem cell transplantation outcome of adult Philadelphia chromosome- positive acute lymphoblastic leukemia. Prospective studies will be of great interest to further confirm the potential benefit of the prophylactic use of tyrosine kinase inhibitors in the post- transplant setting.
Subject: MINIMAL RESIDUAL DISEASE
BONE-MARROW-TRANSPLANTATION
CHRONIC MYELOID-LEUKEMIA
1ST COMPLETE REMISSION
IMATINIB MESYLATE
FOLLOW-UP
REDUCED-INTENSITY
RECEIVING IMATINIB
THERAPY IMPROVES
CHEMOTHERAPY
3121 General medicine, internal medicine and other clinical medicine
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