BACKGROUND: Allogeneic hematopoietic stem cell transplantation (HSCT) is the preferred curative therapy for children with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). We evaluated the treatment outcomes of children with Ph+ ALL who underwent allogeneic HSCT. METHODS: Fifteen children diagnosed with Ph+ ALL in Asan Medical Center Children's Hospital between 1998 and 2012 were retrospectively analyzed. RESULTS: Of 521 children diagnosed with ALL during the study period, 15 had a Philadelphia chromosome. Among these 15 patients, 13 attained complete remission (CR) following induction chemotherapy, and two died of intracerebral hemorrhage during leukapheresis and induction chemotherapy, respectively. Of the 13 patients who attained CR, 12 received allogeneic HSCT, mainly from unrelated donors. Of the 12 patients who received HSCT, one died of a transplant-related cause, one died of relapse after HSCT, and 10 remain in continuous CR. Of the 10 patients who remained in CR longer than six months after HSCT, seven received post-HSCT imatinib. For all 15 patients, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 60.0%, 48.6%, and 38.8%, respectively, with a median follow-up of 70 months. For the HSCT group, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 80.2%, 72.9%, and 29.3%, respectively, with a median follow-up of 100 months. CONCLUSION: Allogeneic HSCT cures a significant proportion of Ph+ ALL patients. Because the use of imatinib appears to be a promising approach, strategies that include tyrosine kinase inhibitors before and after HSCT require further evaluation.
BACKGROUND: Allogeneic hematopoietic stem cell transplantation (HSCT) is the preferred curative therapy for children with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). We evaluated the treatment outcomes of children with Ph+ ALL who underwent allogeneic HSCT. METHODS: Fifteen children diagnosed with Ph+ ALL in Asan Medical Center Children's Hospital between 1998 and 2012 were retrospectively analyzed. RESULTS: Of 521 children diagnosed with ALL during the study period, 15 had a Philadelphia chromosome. Among these 15 patients, 13 attained complete remission (CR) following induction chemotherapy, and two died of intracerebral hemorrhage during leukapheresis and induction chemotherapy, respectively. Of the 13 patients who attained CR, 12 received allogeneic HSCT, mainly from unrelated donors. Of the 12 patients who received HSCT, one died of a transplant-related cause, one died of relapse after HSCT, and 10 remain in continuous CR. Of the 10 patients who remained in CR longer than six months after HSCT, seven received post-HSCT imatinib. For all 15 patients, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 60.0%, 48.6%, and 38.8%, respectively, with a median follow-up of 70 months. For the HSCT group, the 5-year overall survival, event-free survival, and cumulative incidence of relapse were 80.2%, 72.9%, and 29.3%, respectively, with a median follow-up of 100 months. CONCLUSION: Allogeneic HSCT cures a significant proportion of Ph+ ALL patients. Because the use of imatinib appears to be a promising approach, strategies that include tyrosine kinase inhibitors before and after HSCT require further evaluation.
Authors: K R Schultz; A Carroll; N A Heerema; W P Bowman; A Aledo; W B Slayton; H Sather; M Devidas; H W Zheng; S M Davies; P S Gaynon; M Trigg; R Rutledge; D Jorstad; N Winick; M J Borowitz; S P Hunger; W L Carroll; B Camitta Journal: Leukemia Date: 2014-01-20 Impact factor: 11.528
Authors: A Sharathkumar; E F Saunders; Y Dror; R Grant; M Greenberg; S Weitzman; H Chan; S Calderwood; M H Freedman; J Doyle Journal: Bone Marrow Transplant Date: 2004-01 Impact factor: 5.483
Authors: Ginna G Laport; Joseph C Alvarnas; Joycelynne M Palmer; David S Snyder; Marilyn L Slovak; Athena M Cherry; Ruby M Wong; Robert S Negrin; Karl G Blume; Stephen J Forman Journal: Blood Date: 2008-06-02 Impact factor: 22.113
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: Anindita Roy; Mike Bradburn; Anthony V Moorman; Julie Burrett; Sharon Love; Sally E Kinsey; Chris Mitchell; Ajay Vora; Tim Eden; John S Lilleyman; Ian Hann; Vaskar Saha Journal: Br J Haematol Date: 2005-04 Impact factor: 6.998