Impact of post-transplant imatinib administration on Philadelphia chromosome-positive acute lymphoblastic leukaemia.
To evaluate the effect of post-transplant imatinib administration, 34 Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph(+)ALL) patients were retrospectively analysed, with 7 receiving post-transplant imatinib administration. Overall survival was significantly better in patients with post-transplant administration (66.7% vs. 29.6% at 3 years, p=0.03), with no significant difference in leukaemia-free survival (0% vs. 29.6% at 3 years, p=0.29). The median duration of negative minimal residual disease (MRD) in patients with post-transplant imatinib administration was 6 months in the pre-emptive administration group, where imatinib was administered upon detecting MRD after allogeneic stem cell transplantation (allo-SCT). In the prophylactic administration group, imatinib was administered as soon as possible after allo-SCT, and the median duration of MRD was 12 months. In all patients whose observation periods were longer than one year, MRD became positive in both groups leading to haematological relapse. It is therefore concluded that post-transplant imatinib administration is not an ideal treatment for Ph(+)ALL patients whose MRD is positive at allo-SCT.
Nishiwaki
Satoshi
S
Department of Hematology, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya 453-8511, Japan.
Miyamura
Koichi
K
Kato
Chiaki
C
Terakura
Seitaro
S
Ohashi
Kazuteru
K
Sakamaki
Hisashi
H
Nakao
Shinji
S
Harigae
Hideo
H
Kodera
Yoshihisa
Y
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D002648:Child; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D010879:Piperazines / Q000627:therapeutic use*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000628:therapy*; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies; D014184:Transplantation, Homologous
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate