PURPOSE: In a previous analysis of 326 children with Philadelphia chromosome (Ph) -positive acute lymphoblastic leukemia (ALL) treated between 1986 and 1996, hematopoietic stem-cell transplantation from HLA-matched related donors, but not from unrelated donors, offered a superior outcome than chemotherapy alone. To evaluate the impact of recent improvements in chemotherapy and transplantation, we performed a similar analysis on patients treated in the following decade. PATIENTS AND METHODS: We analyzed 610 patients with Ph-positive ALL treated between 1995 and 2005 without tyrosine kinase inhibitor therapy. The median follow-up duration was 6.3 years. RESULTS: Complete remission was achieved in 89% of patients. The 7-year event-free survival and overall survival rates were superior in the present cohort compared with the previous cohort (32.0% ± 2.0% v 25.0% ± 3.0, respectively, P = .007; and 44.9% ± 2.2% v 36.0% ± 3.0%, respectively, P = .017). Compared with chemotherapy alone, transplantation with matched related donors or unrelated donors in first remission (325 patients) showed an advantage with increasing follow-up, suggesting greater protection against late relapses (hazard ratio at 5 years, 0.37; P < .001). In the multivariate Cox regression analysis accounting for treatment (transplantation v no transplantation), age, leukocyte count, and early response had independent impact on treatment outcome. CONCLUSION: Clinical outcome of children and adolescents with Ph-positive ALL has improved with advances in transplantation and chemotherapy. Transplantations with matched related donors and unrelated donors were equivalent and offered better disease control compared with chemotherapy alone. Age, leukocyte count, and early treatment response were independent prognostic indicators. The results of this study will serve as a historical reference to evaluate the therapeutic impact of tyrosine kinase inhibitors on the outcome of Ph-positive ALL.
PURPOSE: In a previous analysis of 326 children with Philadelphia chromosome (Ph) -positive acute lymphoblastic leukemia (ALL) treated between 1986 and 1996, hematopoietic stem-cell transplantation from HLA-matched related donors, but not from unrelated donors, offered a superior outcome than chemotherapy alone. To evaluate the impact of recent improvements in chemotherapy and transplantation, we performed a similar analysis on patients treated in the following decade. PATIENTS AND METHODS: We analyzed 610 patients with Ph-positive ALL treated between 1995 and 2005 without tyrosine kinase inhibitor therapy. The median follow-up duration was 6.3 years. RESULTS: Complete remission was achieved in 89% of patients. The 7-year event-free survival and overall survival rates were superior in the present cohort compared with the previous cohort (32.0% ± 2.0% v 25.0% ± 3.0, respectively, P = .007; and 44.9% ± 2.2% v 36.0% ± 3.0%, respectively, P = .017). Compared with chemotherapy alone, transplantation with matched related donors or unrelated donors in first remission (325 patients) showed an advantage with increasing follow-up, suggesting greater protection against late relapses (hazard ratio at 5 years, 0.37; P < .001). In the multivariate Cox regression analysis accounting for treatment (transplantation v no transplantation), age, leukocyte count, and early response had independent impact on treatment outcome. CONCLUSION: Clinical outcome of children and adolescents with Ph-positive ALL has improved with advances in transplantation and chemotherapy. Transplantations with matched related donors and unrelated donors were equivalent and offered better disease control compared with chemotherapy alone. Age, leukocyte count, and early treatment response were independent prognostic indicators. The results of this study will serve as a historical reference to evaluate the therapeutic impact of tyrosine kinase inhibitors on the outcome of Ph-positive ALL.
Authors: K Schmiegelow; E Forestier; M Hellebostad; M Heyman; J Kristinsson; S Söderhäll; M Taskinen Journal: Leukemia Date: 2009-12-10 Impact factor: 11.528
Authors: A Möricke; M Zimmermann; A Reiter; G Henze; A Schrauder; H Gadner; W D Ludwig; J Ritter; J Harbott; G Mann; T Klingebiel; F Zintl; C Niemeyer; B Kremens; F Niggli; D Niethammer; K Welte; M Stanulla; E Odenwald; H Riehm; M Schrappe Journal: Leukemia Date: 2009-12-10 Impact factor: 11.528
Authors: Olle Ringdén; Steven Z Pavletic; Claudio Anasetti; A John Barrett; Tao Wang; Dan Wang; Joseph H Antin; Paolo Di Bartolomeo; Brian J Bolwell; Christopher Bredeson; Mitchell S Cairo; Robert P Gale; Vikas Gupta; Theresa Hahn; Gregory A Hale; Jorg Halter; Madan Jagasia; Mark R Litzow; Franco Locatelli; David I Marks; Philip L McCarthy; Morton J Cowan; Effie W Petersdorf; James A Russell; Gary J Schiller; Harry Schouten; Stephen Spellman; Leo F Verdonck; John R Wingard; Mary M Horowitz; Mukta Arora Journal: Blood Date: 2008-12-04 Impact factor: 22.113
Authors: J J van Dongen; T Seriu; E R Panzer-Grümayer; A Biondi; M J Pongers-Willemse; L Corral; F Stolz; M Schrappe; G Masera; W A Kamps; H Gadner; E R van Wering; W D Ludwig; G Basso; M A de Bruijn; G Cazzaniga; K Hettinger; A van der Does-van den Berg; W C Hop; H Riehm; C R Bartram Journal: Lancet Date: 1998-11-28 Impact factor: 79.321
Authors: Charles G Mullighan; Christopher B Miller; Ina Radtke; Letha A Phillips; James Dalton; Jing Ma; Deborah White; Timothy P Hughes; Michelle M Le Beau; Ching-Hon Pui; Mary V Relling; Sheila A Shurtleff; James R Downing Journal: Nature Date: 2008-04-13 Impact factor: 49.962
Authors: M Schrappe; M Aricò; J Harbott; A Biondi; M Zimmermann; V Conter; A Reiter; M G Valsecchi; H Gadner; G Basso; C R Bartram; F Lampert; H Riehm; G Masera Journal: Blood Date: 1998-10-15 Impact factor: 22.113
Authors: Giuseppe Basso; Marinella Veltroni; Maria Grazia Valsecchi; Michael N Dworzak; Richard Ratei; Daniela Silvestri; Alessandra Benetello; Barbara Buldini; Oscar Maglia; Giuseppe Masera; Valentino Conter; Maurizio Arico; Andrea Biondi; Giuseppe Gaipa Journal: J Clin Oncol Date: 2009-10-05 Impact factor: 44.544
Authors: Kirk R Schultz; W Paul Bowman; Alexander Aledo; William B Slayton; Harland Sather; Meenakshi Devidas; Chenguang Wang; Stella M Davies; Paul S Gaynon; Michael Trigg; Robert Rutledge; Laura Burden; Dean Jorstad; Andrew Carroll; Nyla A Heerema; Naomi Winick; Michael J Borowitz; Stephen P Hunger; William L Carroll; Bruce Camitta Journal: J Clin Oncol Date: 2009-10-05 Impact factor: 44.544
Authors: C H Pui; D Pei; J T Sandlund; R C Ribeiro; J E Rubnitz; S C Raimondi; M Onciu; D Campana; L E Kun; S Jeha; C Cheng; S C Howard; M L Metzger; D Bhojwani; J R Downing; W E Evans; M V Relling Journal: Leukemia Date: 2009-12-10 Impact factor: 11.528
Authors: Vivien Schäfer; Jana Ernst; Jenny Rinke; Nils Winkelmann; James F Beck; Andreas Hochhaus; Bernd Gruhn; Thomas Ernst Journal: J Cancer Res Clin Oncol Date: 2016-05-11 Impact factor: 4.553
Authors: T Lana; P de Lorenzo; S Bresolin; I Bronzini; M L den Boer; H Cavé; E Froňková; M Stanulla; M Zaliova; C J Harrison; H de Groot; M G Valsecchi; A Biondi; G Basso; G Cazzaniga; G te Kronnie Journal: Leukemia Date: 2015-03-17 Impact factor: 11.528
Authors: Stephen P Hunger; Mignon L Loh; James A Whitlock; Naomi J Winick; William L Carroll; Meenakshi Devidas; Elizabeth A Raetz Journal: Pediatr Blood Cancer Date: 2012-12-19 Impact factor: 3.167