Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/9611
Title: Adult philadelphia chromosome-positive acute lymphoblastic leukemia in daily practice: A multicenter experience
Authors: Tekgündüz, E.
Göker, H.
Kaynar, L.
Sarı, Hakan İsmail
Pala, Ç.
Dogu, Mehmet Hilmi
Öztürk, E.
Keywords: Acute lymphoblastic leukemia
Allogeneic transplantation
BCR-ABL
Philadelphia chromosome
Stem cell transplantation
antineoplastic agent
cyclosporin
dasatinib
imatinib
methotrexate
protein kinase inhibitor
acute lymphoblastic leukemia
adult
aged
allotransplantation
Article
cancer chemotherapy
cancer patient
cancer survival
clinical article
cohort analysis
female
graft versus host reaction
hematopoietic cell
human
leukemia remission
male
medical practice
overall survival
Philadelphia chromosome positive cell
retrospective study
treatment response
adverse effects
clinical trial
disease management
hematopoietic stem cell transplantation
middle aged
mortality
multicenter study
multimodality cancer therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma
procedures
survival analysis
treatment outcome
young adult
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Combined Modality Therapy
Disease Management
Female
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Protein Kinase Inhibitors
Retrospective Studies
Survival Analysis
Treatment Outcome
Young Adult
Publisher: Elsevier Inc.
Abstract: In this retrospective, multicenter study, we evaluated the real-life outcomes of adult Philadelphia-positive acute lymphoblastic leukemia patients. The best results in terms of survival are achieved in patients who were treated with tyrosine kinase inhibitors during induction and received allogeneic hematopoietic cell transplantation as part of consolidation. Background The prognosis of Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) is generally poor. Currently, allogeneic hematopoietic cell transplantation (allo-HCT) is the only accepted therapy with curative potential. Patients and Methods Herein, we report our multicenter, retrospective experience with 46 (23 female; 23 male) Ph+ ALL patients, who were treated off-study between 2005 and 2012. Results The median age of the patients was 46 years (range, 19-73 years). During induction, 30 (65%), 13 (28%), and 3 (7%) patients received tyrosine kinase inhibitors (TKIs) concurrent with chemotherapy (TKIs/chemotherapy), chemotherapy only, and TKIs only, respectively. Following induction, rates of complete remission (CR) of the study population were 85% (n = 39). CR rate in patients receiving TKIs during induction (n = 33) was significantly higher compared with patients who received chemotherapy only (n = 13; P =.011). Taking TKIs during induction significantly reduced induction mortality (3.3% vs. 38%; P =.01). Allo-HCT was performed subsequently in 21 (46%) patients. More patients who received TKIs with or without chemotherapy (19/33; 58%) during induction were able to undergo to allo-HCT compared with patients who received chemotherapy only (2/13; 15%; P =.005). Median overall survival of patients who were treated with TKIs during induction and received allo-HCT (not reached; NR) was significantly prolonged compared with patients who received allo-HCT but without TKIs during induction (23.2 months) and to the rest of the cohort (21.2 months; P =.019). Conclusions Current state-of-the art management of Ph+ ALL in real-life seems to be incorporation of TKIs to chemotherapy regimens and proceeding to allo-HCT, whenever possible. © 2016 Elsevier Inc. All rights reserved.
URI: https://hdl.handle.net/11499/9611
https://doi.org/10.1016/j.clml.2016.01.007
ISSN: 2152-2650
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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