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- Title
Adult Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in Daily Practice: A Multicenter Experience.
- Authors
Tekgündüz, Emre; Göker, Hakan; Kaynar, Leylagül; Sarı, İsmail; Pala, Çiğdem; Doğu, Mehmet Hilmi; Öztürk, Erman; Turgut, Burhan; Korkmaz, Serdal; Tetik, Ayşegül; Büyükaşık, Yahya; Hacıoğlu, Sibel Kabukçu; Bozdağ, Sinem Civriz; Özdemir, Evren; Altuntaş, Fevzi
- Abstract
<bold>Background: </bold>The prognosis of Philadelphia-positive acute lymphoblastic leukemia (Ph(+) ALL) is generally poor. Currently, allogeneic hematopoietic cell transplantation (allo-HCT) is the only accepted therapy with curative potential.<bold>Patients and Methods: </bold>Herein, we report our multicenter, retrospective experience with 46 (23 female; 23 male) Ph(+) ALL patients, who were treated off-study between 2005 and 2012.<bold>Results: </bold>The median age of the patients was 46 years (range, 19-73 years). During induction, 30 (65%), 13 (28%), and 3 (7%) patients received tyrosine kinase inhibitors (TKIs) concurrent with chemotherapy (TKIs/chemotherapy), chemotherapy only, and TKIs only, respectively. Following induction, rates of complete remission (CR) of the study population were 85% (n = 39). CR rate in patients receiving TKIs during induction (n = 33) was significantly higher compared with patients who received chemotherapy only (n = 13; P = .011). Taking TKIs during induction significantly reduced induction mortality (3.3% vs. 38%; P = .01). Allo-HCT was performed subsequently in 21 (46%) patients. More patients who received TKIs with or without chemotherapy (19/33; 58%) during induction were able to undergo to allo-HCT compared with patients who received chemotherapy only (2/13; 15%; P = .005). Median overall survival of patients who were treated with TKIs during induction and received allo-HCT (not reached; NR) was significantly prolonged compared with patients who received allo-HCT but without TKIs during induction (23.2 months) and to the rest of the cohort (21.2 months; P = .019).<bold>Conclusions: </bold>Current state-of-the art management of Ph(+) ALL in real-life seems to be incorporation of TKIs to chemotherapy regimens and proceeding to allo-HCT, whenever possible.
- Subjects
ANTINEOPLASTIC agents; LYMPHOBLASTIC leukemia treatment; LYMPHOBLASTIC leukemia diagnosis; COMBINED modality therapy; COMPARATIVE studies; HEMATOPOIETIC stem cell transplantation; LYMPHOBLASTIC leukemia; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; SURVIVAL analysis (Biometry); DISEASE management; EVALUATION research; TREATMENT effectiveness; RETROSPECTIVE studies; PROTEIN kinase inhibitors; THERAPEUTICS
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2016, Vol 16, Issue 5, p269
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2016.01.007