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Tyrosine kinase inhibitors improve long-term outcome of allogeneic hematopoietic stem cell transplantation for adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia.
- Source :
-
Haematologica [Haematologica] 2015 Mar; Vol. 100 (3), pp. 392-9. Date of Electronic Publication: 2014 Dec 19. - Publication Year :
- 2015
-
Abstract
- This study aimed to determine the impact of tyrosine kinase inhibitors given pre- and post-allogeneic stem cell transplantation on long-term outcome of patients allografted for Philadelphia chromosome-positive acute lymphoblastic leukemia. This retrospective analysis from the EBMT Acute Leukemia Working Party included 473 de novo Philadelphia chromosome-positive acute lymphoblastic leukemia patients in first complete remission who underwent an allogeneic stem cell transplantation using a human leukocyte antigen-identical sibling or human leukocyte antigen-matched unrelated donor between 2000 and 2010. Three hundred and ninety patients received tyrosine kinase inhibitors before transplant, 329 at induction and 274 at consolidation. Kaplan-Meier estimates of leukemia-free survival, overall survival, cumulative incidences of relapse incidence, and non-relapse mortality at five years were 38%, 46%, 36% and 26%, respectively. In multivariate analysis, tyrosine-kinase inhibitors given before allogeneic stem cell transplantation was associated with a better overall survival (HR=0.68; P=0.04) and was associated with lower relapse incidence (HR=0.5; P=0.01). In the post-transplant period, multivariate analysis identified prophylactic tyrosine-kinase inhibitor administration to be a significant factor for improved leukemia-free survival (HR=0.44; P=0.002) and overall survival (HR=0.42; P=0.004), and a lower relapse incidence (HR=0.40; P=0.01). Over the past decade, administration of tyrosine kinase inhibitors before allogeneic stem cell transplantation has significantly improved the long-term allogeneic stem cell transplantation outcome of adult Philadelphia chromosome-positive acute lymphoblastic leukemia. Prospective studies will be of great interest to further confirm the potential benefit of the prophylactic use of tyrosine kinase inhibitors in the post-transplant setting.<br /> (Copyright© Ferrata Storti Foundation.)
- Subjects :
- Adolescent
Adult
Aged
Female
Histocompatibility Testing
Humans
Male
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma immunology
Precursor Cell Lymphoblastic Leukemia-Lymphoma mortality
Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology
Prognosis
Remission Induction
Retrospective Studies
Siblings
Survival Analysis
Time Factors
Transplantation, Homologous
Treatment Outcome
Unrelated Donors
Antineoplastic Agents therapeutic use
Hematopoietic Stem Cell Transplantation
Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy
Protein Kinase Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1592-8721
- Volume :
- 100
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Haematologica
- Publication Type :
- Academic Journal
- Accession number :
- 25527562
- Full Text :
- https://doi.org/10.3324/haematol.2014.116954