Tyrosine kinase inhibitors improve long-term outcome of allogeneic hematopoietic stem cell transplantation for adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia.

Research output: Contribution to journalArticle

Abstract

This study aimed to determine the impact of tyrosine-kinase inhibitors given pre- and post-allogeneic stem cell transplantation on long term outcome of patients allografted for Philadelphia chromosome-positive acute lymphoblastic leukemia. This retrospective analysis from the Acute Leukemia Working Party of EBMT included 473 de novo Philadelphia chromosome-positive acute lymphoblastic leukemia patients in first complete remission who underwent an allogeneic stem cell transplantation using an human leucocyte antigen-identical sibling or human leucocyte antigen-matched unrelated donor between 2000 and 2010. Three hundred ninety patients received tyrosine-kinase inhibitors before transplant, 329 at induction and 274 at consolidation. The Kaplan-Meier estimates of leukemia-free survival, overall survival, cumulative incidences of relapse incidence, and non-relapse mortality at 5 years were 38%, 46%, 36% and 26%, respectively. In multivariate analysis, tyrosine-kinase inhibitors given before allogeneic stem cell transplantation was associated with a better overall survival (HR=0.68; P=.04) and was associated with lower relapse incidence (HR=0.5; P=.01). In the post-transplant period, multivariate analysis identified prophylactic tyrosine-kinase inhibitors administration to be a significant factor for improved leukemia-free survival (HR=0.44; P=.002) and overall survival (HR=0.42; P=.004), and a lower relapse incidence (HR=0.40; P=.01). In conclusion, over the past decade, tyrosine-kinase inhibitors administration before allogeneic stem cell transplantation has significantly improved the long term allogeneic stem cell transplantation outcome of adult Philadelphia chromosome-positive acute lymphoblastic leukemia. Prospective studies will be of great interest to further confirm the potential benefit of the prophylactic use of tyrosine-kinase inhibitors in the post-transplant setting.

Details

Authors
  • Eolia Brissot
  • Myriam Labopin
  • Marielle M Beckers
  • Gérard Socié
  • Alessandro Rambaldi
  • Liisa Volin
  • Jürgen Finke
  • Stig Lenhoff
  • Nicolaus Kröger
  • Gert J Ossenkoppele
  • Charles F Craddock
  • Ibrahim Yakoub-Agha
  • Günhan Gürman
  • Nigel H Russell
  • Mahmoud Aljurf
  • Michael N Potter
  • Arnon Nagler
  • Oliver Ottmann
  • Jan J Cornelissen
  • Jordi Esteve
  • And 1 others
  • Mohamad Mohty
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology
Original languageEnglish
Pages (from-to)392-399
JournalHaematologica
Volume100
Issue number3
Publication statusPublished - 2015
Publication categoryResearch
Peer-reviewedYes

Total downloads

No data available