Intermediate dose of imatinib in combination with chemotherapy followed by allogeneic stem cell transplantation improves early outcome in paediatric Philadelphia chromosome-positive acute lymphoblastic leukaemia (ALL): results of the Spanish Cooperative Group SHOP studies ALL-94, ALL-99 and ALL-2005
Por:
Rives, S, Estella, J, Gomez, P, Lopez-Duarte, M, de Miguel, PG, Verdeguer, A, Moreno, MJ, Vivanco, JL, Couselo, JM, Fernandez-Delgado, R, Maldonado, M, Tasso, M, Lopez-Ibor, B, Lendinez, F, Lopez-Almaraz, R, Uriz, J, Melo, M, Fernandez-Teijeiro, A, Rodriguez, I, Badell, I
Publicada:
1 sep 2011
Resumen:
Philadelphia-chromosome acute lymphoblastic leukaemia (Ph+ ALL) is a subgroup of ALL with very high risk of treatment failure. We report here the results of the Sociedad Espanola de Hematologia y Oncologia Pediatricas (SEHOP/SHOP) in paediatric Ph+ ALL treated with intermediate-dose imatinib concurrent with intensive chemotherapy. The toxicities and outcome of these patients were compared with historical controls not receiving imatinib. Patients with Ph+ ALL aged 1-18 years were enrolled in three consecutive ALL/SHOP trials (SHOP-94/SHOP-99/SHOP-2005). In the SHOP-2005 trial, imatinib (260 mg/m(2) per day) was given on day-15 of induction. Allogeneic haematopoietic stem-cell transplantation (HSCT) from a matched related or unrelated donor was scheduled in first complete remission (CR1). Forty-three patients were evaluable (22 boys, median age 6.8 years, range, 1.2-15). Sixteen received imatinib whereas 27 received similar chemotherapy without imatinib. Seventeen of 27 and 15 of 16 patients in the non-imatinib and imatinib cohort, respectively, underwent HSCT in CRI. With a median follow-up of 109 and 39 months for the non-imatinib and imatinib cohorts, the 3-year event-free survival (EFS) was 29.6% and 78.7%, respectively (P = 0.01). These results show that, compared to historical controls, intermediate dose of imatinib given concomitantly with chemotherapy and followed by allogeneic HSCT markedly improved early EFS in paediatric Ph+ ALL.
Filiaciones:
Rives, S:
Hosp St Joan de Deu Barcelona, Paediat Haematol Dept, Barcelona 08950, Spain
Univ Barcelona, Barcelona, Spain
Estella, J:
Hosp St Joan de Deu Barcelona, Paediat Haematol Dept, Barcelona 08950, Spain
Gomez, P:
Hosp Reina Sofia, Cordoba, Spain
Lopez-Duarte, M:
Hosp Univ Marques de Valdecilla, Santander, Spain
de Miguel, PG:
Hosp Univ La Paz, Madrid, Spain
Verdeguer, A:
Hosp Univ La Fe, Valencia, Spain
Moreno, MJ:
Hosp Virgen de las Nieves, Granada, Spain
Vivanco, JL:
Hosp Doce de Octubre, Madrid, Spain
Couselo, JM:
Hosp Xeral de Galicia, Santiago De Compostela, Spain
Fernandez-Delgado, R:
Hosp Clin Valencia, Valencia, Spain
Maldonado, M:
Hosp Ramon & Cajal, E-28034 Madrid, Spain
Tasso, M:
Hosp Univ Alicante, Alicante, Spain
Lopez-Ibor, B:
Hosp Monteprincipe, Madrid, Spain
Lendinez, F:
Hosp Torrecardenas, Almeria, Spain
Lopez-Almaraz, R:
Hosp Univ Canarias, San Cristobal De Laguna, Spain
Uriz, J:
Hosp Donostia, San Sebastian, Spain
Melo, M:
Hosp Parc Tauli, Sabadell, Spain
Fernandez-Teijeiro, A:
Hosp Virgen de la Macarena, Seville, Spain
Rodriguez, I:
Hosp Maria Teresa Herrera Juan Canalejo, La Coruna, Spain
Badell, I:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Barcelona, Spain
Bronze
|