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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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