title: Impact of MRD and TKI on allogeneic hematopoietic cell transplantation for Ph+ALL: a study from the adult ALL WG of the JSHCT.
abstract: To assess the impact of minimal residual disease (MRD) and tyrosine kinase inhibitor (TKI) administration on allogeneic hematopoietic cell transplantation (allo-HCT) for Ph-positive ALL (Ph+ALL), we retrospectively analyzed data from a registry database for 432 adult Ph+ALL patients in first CR (CR1) who received pre-transplant TKI administration. Negative MRD (MRD(-)) at allo-HCT was achieved in 277 patients. OS in patients transplanted in MRD(-) was significantly better than that in patients transplanted in MRD(+) (MRD(-): 67% vs MRD(+): 55% at 4 years; P=0.001). MRD(-) at allo-HCT was a significant risk factor for survival along with age at allo-HCT in multivariate analyses. Incidence of relapse in patients transplanted in MRD(-) was significantly lower than that in patients transplanted in MRD(+) (MRD(-): 19% vs MRD(+): 29% at 4 years; P=0.006). In multivariate analyses, MRD(+) at allo-HCT was a significant risk factor for relapse. A post-transplant TKI was administered to 103 patients. In subanalyses regarding the effect of post-transplant TKI administration, post-transplant TKI administration was a significant risk factor for relapse in multivariate analyses (P<0.0001). MRD status at allo-HCT is one of the most important predictive factors for Ph+ALL patients transplanted in CR1.
authors.affiliation: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.|Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan.|Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nishiwaki
authors.affiliation: Department of Hematology, Sapporo Hokuyu Hospital, Sappro, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Imai
authors.affiliation: Department of Hematology, Fujita Health University Hospital, Toyoake, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Mizuta
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kanamori
authors.affiliation: Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ohashi
authors.affiliation: Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Onishi
authors.affiliation: Division of Molecular Therapy, Institute of Medical Science, The Advanced Clinical Research Center, University of Tokyo, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Uchida
authors.affiliation: Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Eto
authors.affiliation: Department of Hematology, Osaka City University Hospital, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nakamae
authors.affiliation: Third Department of Internal of Medicine, Yamaguchi University School of Medicine, Ube, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yujiri
authors.affiliation: Department of Hematology and Oncology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Mori
authors.affiliation: Department of Cell Processing and Transfusion, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nagamura-Inoue
authors.affiliation: Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan.|Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Atsuta
authors.affiliation: Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy*; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage*; D012042:Registries
chemical_list: D047428:Protein Kinase Inhibitors