RT Journal Article
T1 Incidence and outcome after first molecular versus overt recurrence in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia included in the ALL Ph08 trial from the Spanish PETHEMA Group.
A1 Ribera, Josep-Maria
A1 Garcia, Olga
A1 Moreno, Maria-Jose
A1 Barba, Pere
A1 Garcia-Cadenas, Irene
A1 Mercadal, Santiago
A1 Montesinos, Pau
A1 Barrios, Manuel
A1 Gonzalez-Campos, Jose
A1 Martinez-Carballeira, Daniel
A1 Gil, Cristina
A1 Ribera, Jordi
A1 Vives, Susana
A1 Novo, Andres
A1 Cervera, Marta
A1 Serrano, Josefina
A1 Lavilla, Esperanza
A1 Abella, Eugenia
A1 Tormo, Mar
A1 Amigo, Maria-Luz
A1 Artola, Maria-Teresa
A1 Genesca, Eulalia
A1 Bravo, Pilar
A1 Garcia-Belmonte, Daniel
A1 Garcia-Guiñon, Antoni
A1 Hernandez-Rivas, Jesus-Maria
A1 Feliu, Evarist
K1 Philadelphia chromosome-positive acute lymphoblastic leukemia
K1 Clinical disease recurrence
K1 Molecular disease recurrence
K1 Outcome
AB Disease recurrence occurs in 20% to 40% of adults with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who are treated with chemotherapy and tyrosine kinase inhibitors (TKIs). In the current study, the authors report the incidence, treatment, and outcome after first disease recurrence in young and older adults treated in the ALL Ph08 trial (ClinicalTrials.gov identifier NCT01491763). Patients aged 18 to 55 years with de novo Ph+ ALL were treated with imatinib concurrently with standard-dose induction and consolidation therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) when possible. In patients with first disease recurrence, the authors analyzed the type of recurrence, timing, location, presence of kinase domain mutations, type of treatment, and outcomes. Of the 125 patients, 28 patients (22%) developed disease recurrence before (4 patients) or after (24 patients) HSCT, with the recurrences being molecular in 11 patients (39%) and overt in 17 patients (61%). T315I was the most common mutation noted at the time of disease recurrence. Change in TKI was the most frequent treatment for patients with molecular disease recurrence whereas rescue chemotherapy and TKI change followed by second allo-HSCT when possible were performed for the most part in patients with overt disease recurrence. A total of 20 patients (71%) achieved response. The median disease-free survival (DFS) and overall survival (OS) were 8.5 months and 15.3 months, respectively. A trend for better DFS and OS was observed in patients with molecular recurrence compared with those with overt recurrence (median of 16.9 months vs 6.3 months [P = .05] and 28.7 months vs 11.5 months [P = .05] for DFS and OS, respectively). Disease recurrence was frequent in young and older adults with Ph+ ALL who were treated with imatinib and chemotherapy with HSCT. Although the majority of patients responded to rescue therapy, their outcomes were poor, especially with regard to overt disease recurrence.
PB Wiley
YR 2019
FD 2019-07-29
LK http://hdl.handle.net/10668/13867
UL http://hdl.handle.net/10668/13867
LA en
NO Ribera JM, García O, Moreno MJ, Barba P, García-Cadenas I, Mercadal S, et al. Incidence and outcome after first molecular versus overt recurrence in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia included in the ALL Ph08 trial from the Spanish PETHEMA Group. Cancer. 2019 Aug 15;125(16):2810-2817
DS RISalud
RD Apr 17, 2025