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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
DISEASE relapse prevention
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
Subjects
Details
- Language :
- English
- ISSN :
- 09395555
- Volume :
- 100
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- Annals of Hematology
- Publication Type :
- Academic Journal
- Accession number :
- 150853632
- Full Text :
- https://doi.org/10.1007/s00277-021-04504-0