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- Title
Imatinib and methylprednisolone alternated with chemotherapy improve the outcome of elderly patients with Philadelphia-positive acute lymphoblastic leukemia: results of the GRAALL AFR09 study.
- Authors
Delannoy, A.; Delabesse, E.; Lhéritier, V.; Castaigne, S.; Rigal-Huguet, F.; Raffoux, E.; Garban, F.; Legrand, O.; Bologna, S.; Dubruille, V.; Turlure, P.; Reman, O.; Delain, M.; Isnard, F.; Coso, D.; Raby, P.; Buzyn, A.; Caillères, S.; Darre, S.; Fohrer, C.
- Abstract
Acute lymphoblastic leukemia (ALL) in the elderly is characterized by its ominous prognosis. On the other hand, imatinib has demonstrated remarkable, although transient, activity in relapsed and refractory Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL), which prompted us to assess the use of imatinib in previously untreated elderly patients. ALL patients aged 55 years or older were given steroids during 1 week. Ph+ve cases were then offered a chemotherapy-based induction followed by a consolidation phase with imatinib and steroids during 2 months. Patients in complete response (CR) after consolidation were given 10 maintenance blocks of alternating chemotherapy, including two additional 2-month blocks of imatinib. Thirty patients were included in this study and are compared with 21 historical controls. Out of 29 assessable patients, 21 (72%, confidence interval (CI): 53–87%) were in CR after induction chemotherapy vs 6/21 (29%, CI: 11–52%) in controls (P=0.003). Five additional CRs were obtained after salvage with imatinib and four after salvage with additional chemotherapy in the control group. Overall survival (OS) is 66% at 1 year vs 43% in the control group (P=0.005). The 1-year relapse-free survival is 58 vs 11% (P=0.0003). The use of imatinib in elderly patients with Ph+ ALL is very likely to improve outcome, including OS.Leukemia (2006) 20, 1526–1532. doi:10.1038/sj.leu.2404320; published online 13 July 2006
- Subjects
LYMPHOBLASTIC leukemia; IMATINIB; DRUG therapy; STEROIDS; CHROMOSOME abnormalities
- Publication
Leukemia (08876924), 2006, Vol 20, Issue 9, p1526
- ISSN
0887-6924
- Publication type
Article
- DOI
10.1038/sj.leu.2404320