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Favorable outcome of allogeneic hematopoietic stem cell transplantation followed by post-transplant treatment with imatinib in children with Philadelphia chromosome-positive acute lymphoblastic leukemia.

Byun YJ, Suh JK, Lee SW, Lee D, Kim H, Choi ES, Koh KN, Im HJ, Seo JJ - Blood Res (2015)

Bottom Line: Of 521 children diagnosed with ALL during the study period, 15 had a Philadelphia chromosome.Among these 15 patients, 13 attained complete remission (CR) following induction chemotherapy, and two died of intracerebral hemorrhage during leukapheresis and induction chemotherapy, respectively.For all 15 patients, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 60.0%, 48.6%, and 38.8%, respectively, with a median follow-up of 70 months.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is the preferred curative therapy for children with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). We evaluated the treatment outcomes of children with Ph+ ALL who underwent allogeneic HSCT.

Methods: Fifteen children diagnosed with Ph+ ALL in Asan Medical Center Children's Hospital between 1998 and 2012 were retrospectively analyzed.

Results: Of 521 children diagnosed with ALL during the study period, 15 had a Philadelphia chromosome. Among these 15 patients, 13 attained complete remission (CR) following induction chemotherapy, and two died of intracerebral hemorrhage during leukapheresis and induction chemotherapy, respectively. Of the 13 patients who attained CR, 12 received allogeneic HSCT, mainly from unrelated donors. Of the 12 patients who received HSCT, one died of a transplant-related cause, one died of relapse after HSCT, and 10 remain in continuous CR. Of the 10 patients who remained in CR longer than six months after HSCT, seven received post-HSCT imatinib. For all 15 patients, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 60.0%, 48.6%, and 38.8%, respectively, with a median follow-up of 70 months. For the HSCT group, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 80.2%, 72.9%, and 29.3%, respectively, with a median follow-up of 100 months.

Conclusion: Allogeneic HSCT cures a significant proportion of Ph+ ALL patients. Because the use of imatinib appears to be a promising approach, strategies that include tyrosine kinase inhibitors before and after HSCT require further evaluation.

No MeSH data available.


Related in: MedlinePlus

Five-year OS and EFS outcomes for Ph+ ALL study patients who underwent HSCT (N=12).
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Figure 2: Five-year OS and EFS outcomes for Ph+ ALL study patients who underwent HSCT (N=12).

Mentions: For the 15 study patients, the 5-year OS was 60.0% (Standard error [SE], 14.2%) and the EFS was 48.6% (SE, 14.1%), with a median follow-up of 70 months (Fig. 1). For the specific HSCT group (N=12), the 5-year OS and EFS were 80.2% (SE, 12.8%) and 72.9% (SE, 13.6%), respectively, with a median follow-up of 100 months (Fig. 2). Seven patients who received pre- and post-HSCT imatinib treatment were alive without relapse.


Favorable outcome of allogeneic hematopoietic stem cell transplantation followed by post-transplant treatment with imatinib in children with Philadelphia chromosome-positive acute lymphoblastic leukemia.

Byun YJ, Suh JK, Lee SW, Lee D, Kim H, Choi ES, Koh KN, Im HJ, Seo JJ - Blood Res (2015)

Five-year OS and EFS outcomes for Ph+ ALL study patients who underwent HSCT (N=12).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4595580&req=5

Figure 2: Five-year OS and EFS outcomes for Ph+ ALL study patients who underwent HSCT (N=12).
Mentions: For the 15 study patients, the 5-year OS was 60.0% (Standard error [SE], 14.2%) and the EFS was 48.6% (SE, 14.1%), with a median follow-up of 70 months (Fig. 1). For the specific HSCT group (N=12), the 5-year OS and EFS were 80.2% (SE, 12.8%) and 72.9% (SE, 13.6%), respectively, with a median follow-up of 100 months (Fig. 2). Seven patients who received pre- and post-HSCT imatinib treatment were alive without relapse.

Bottom Line: Of 521 children diagnosed with ALL during the study period, 15 had a Philadelphia chromosome.Among these 15 patients, 13 attained complete remission (CR) following induction chemotherapy, and two died of intracerebral hemorrhage during leukapheresis and induction chemotherapy, respectively.For all 15 patients, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 60.0%, 48.6%, and 38.8%, respectively, with a median follow-up of 70 months.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is the preferred curative therapy for children with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). We evaluated the treatment outcomes of children with Ph+ ALL who underwent allogeneic HSCT.

Methods: Fifteen children diagnosed with Ph+ ALL in Asan Medical Center Children's Hospital between 1998 and 2012 were retrospectively analyzed.

Results: Of 521 children diagnosed with ALL during the study period, 15 had a Philadelphia chromosome. Among these 15 patients, 13 attained complete remission (CR) following induction chemotherapy, and two died of intracerebral hemorrhage during leukapheresis and induction chemotherapy, respectively. Of the 13 patients who attained CR, 12 received allogeneic HSCT, mainly from unrelated donors. Of the 12 patients who received HSCT, one died of a transplant-related cause, one died of relapse after HSCT, and 10 remain in continuous CR. Of the 10 patients who remained in CR longer than six months after HSCT, seven received post-HSCT imatinib. For all 15 patients, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 60.0%, 48.6%, and 38.8%, respectively, with a median follow-up of 70 months. For the HSCT group, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 80.2%, 72.9%, and 29.3%, respectively, with a median follow-up of 100 months.

Conclusion: Allogeneic HSCT cures a significant proportion of Ph+ ALL patients. Because the use of imatinib appears to be a promising approach, strategies that include tyrosine kinase inhibitors before and after HSCT require further evaluation.

No MeSH data available.


Related in: MedlinePlus