Combination of intensive chemotherapy and imatinib can rapidly induce high-quality complete remission for a majority of patients with newly diagnosed BCR-ABL-positive acute lymphoblastic leukemia

Abstract

for the Japan Adult Leukemia Study GroupThe outcome for adult patients with BCR-ABL-positive acute lymphoblastic leukemia (ALL) remains dismal and long-term survival can hardly be achieved except by allogeneic hematopoietic stem cell transplantation (HSCT). The Japan Adult Leukemia Study Group (JALSG) has recently started a phase 2 trial with intensive chemotherapy and imatinib for newly diagnosed BCR-AB-positive ALL patients, and we present here the interim results for the first 24 patients. All patients except one case of early death (96%) attained complete remission (CR) after a single course of remission induction therapy. Polymerase chain reaction (PCR) negativity was achieved in 28% of the patients on day 28, in 50% on day 63, and in up to 78% during the follow-up period. The toxicity profile was almost similar to that with chemotherapy alone. As a result, 15 patients (63%) could receive an allogeneic HSC transplant during their first CR. Although the number of patients is small and the observation period is too short, the combination therapy is very promising and produces high-quality CR for most newly diagnosed patients with BCR-ABL-positive ALL. This is especially useful because it provides the patients with a better chance to receive an allogeneic HSC transplant. (Blood. 2004;104:3507-3512)

Autologous stem cell transplantation in adults with acute lymphoblastic leukemia in first complete remission: analysis of the LALA-85, -87 and -94 trials

“…Importantly, patients with Ph-positive ALL are now treated with imatinib-containing regimens in specific studies that appear to highly improve the outcome of these high-risk patients. [41][42][43] Otherwise, the choice between ASCT or chemotherapy is still open. One may consider that the use of ASCT significantly reduces the total duration of treatment.…”

Patient-reported quality of life after allogeneic hematopoietic cell transplantation or chemotherapy for acute leukemia

“…Improvements in these treatment modalities [1][2][3][4][5][6][7][8] have resulted in a growing number of acute leukemia survivors. Allo-HCT is a potentially curative treatment strategy that reduces the risk of relapse, however, it carries an attendant risk of significant acute complications and late effects that may lead to non-relapse mortality.…”

Clinico-hematological, immunophenotyping, and molecular transcript profile of BCR–ABL-positive B cell acute lymphoblastic leukemias

“…Imatinib is started at a dose of 300 mg/day and continued into consolidation and maintenance phase. Several studies [18][19][20][21] have reported increased CHR with the addition of imatinib to chemotherapy regimen. Our study results also show a high CHR rate of 77 % (10/ 13) with use of imatinib in induction regimen.…”