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The role of ponatinib in adult BCR-ABL1 positive acute lymphoblastic leukemia after allogeneic transplantation: a real-life retrospective multicenter study.
- Source :
-
Annals of Hematology . Jul2021, Vol. 100 Issue 7, p1743-1753. 11p. - Publication Year :
- 2021
-
Abstract
- The experience of third-generation tyrosine kinase inhibitor ponatinib treatment in Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph'+ ALL) patients post-allogeneic transplantation is limited. We retrospectively collected data on 25 Ph'+ ALL patients who were started on ponatinib after allogeneic transplantation between July 2015 and July 2019 from nine transplantation centers in Italy. Ponatinib was given in prophylaxis in five (20%), as pre-emptive treatment in seven (28%), and as salvage therapy in thirteen (52%) patients. It was combined with donor leukocyte infusions in ten patients. Half of the patients (12/25) harbored T315I mutation of BCR/ABL1, while in the remaining mutational analysis was negative or not performed. Among the 20 patients who received ponatinib as pre-emptive/salvage treatment, complete molecular response was achieved in 15 (75%) patients. Estimated overall survival at 2-year post-initiation of treatment in the whole cohort was 65% (respectively 60%, 60%, and 78% for the prophylaxis, pre-emptive, and salvage therapy groups). In patients with T315I-positive mutational status, the estimated 2-year survival was 40%. Fourteen patients (56%) experienced toxicity, requiring temporary or definitive suspension of treatment. In conclusion, treatment of Ph'+ ALL patients with ponatinib after transplantation is effective, although the question of adequate drug dose and treatment duration remains unanswered. [ABSTRACT FROM AUTHOR]
- Subjects :
- *LYMPHOBLASTIC leukemia
*ACUTE leukemia
*PROTEIN-tyrosine kinase inhibitors
*ADULTS
*OVERALL survival
*LYMPHOBLASTIC leukemia treatment
*PROTEINS
*RESEARCH
*HOMOGRAFTS
*HETEROCYCLIC compounds
*RESEARCH methodology
*RETROSPECTIVE studies
*MEDICAL cooperation
*EVALUATION research
*IMIDAZOLES
*DISEASE relapse
*COMPARATIVE studies
*SURVIVAL analysis (Biometry)
*CHROMOSOME abnormalities
*COMBINED modality therapy
*SALVAGE therapy
*HEMATOPOIETIC stem cell transplantation
*CHEMOPREVENTION
*ACUTE diseases
DISEASE relapse prevention
Subjects
Details
- Language :
- English
- ISSN :
- 09395555
- Volume :
- 100
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Annals of Hematology
- Publication Type :
- Academic Journal
- Accession number :
- 150853632
- Full Text :
- https://doi.org/10.1007/s00277-021-04504-0