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- Title
Pre-transplant imatinib-based therapy improves the outcome of allogeneic hematopoietic stem cell transplantation for BCR-ABL-positive acute lymphoblastic leukemia.
- Authors
Mizuta, S.; Matsuo, K.; Yagasaki, F.; Yujiri, T.; Hatta, Y.; Kimura, Y.; Ueda, Y.; Kanamori, H.; Usui, N.; Akiyama, H.; Miyazaki, Y.; Ohtake, S.; Atsuta, Y.; Sakamaki, H.; Kawa, K.; Morishima, Y.; Ohnishi, K.; Naoe, T.; Ohno, R.
- Abstract
A high complete remission (CR) rate has been reported in newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) following imatinib-based therapy. However, the overall effect of imatinib on the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is undetermined. Between 2002 and 2005, 100 newly diagnosed adult patients with Ph+ALL were registered to a phase II study of imatinib-combined chemotherapy (Japan Adult Leukemia Study Group Ph+ALL202 study) and 97 patients achieved CR. We compared clinical outcomes of 51 patients who received allo-HSCT in their first CR (imatinib cohort) with those of 122 historical control patients in the pre-imatinib era (pre-imatinib cohort). The probability of overall survival at 3 years after allo-HSCT was 65% (95% confidence interval (CI), 49-78%) for the imatinib cohort and 44% (95% CI, 35-52%) for the pre-imatinib cohort. Multivariate analysis confirmed that this difference was statistically significant (adjusted hazard ratio, 0.44, P=0.005). Favorable outcomes of the imatinib cohort were also observed for disease-free survival (P=0.007) and relapse (P=0.002), but not for non-relapse mortality (P=0.265). Imatinib-based therapy is a potentially useful strategy for newly diagnosed patients with Ph+ALL, not only providing them more chance to receive allo-HSCT, but also improving the outcome of allo-HSCT.
- Subjects
LYMPHOBLASTIC leukemia; HEMATOPOIETIC stem cell transplantation; DRUG therapy; CONFIDENCE intervals; MULTIVARIATE analysis; DISEASE relapse; IMATINIB; GENETICS
- Publication
Leukemia (08876924), 2011, Vol 25, Issue 1, p41
- ISSN
0887-6924
- Publication type
Article
- DOI
10.1038/leu.2010.228