PMID- 20606084
OWN - NLM
STAT- MEDLINE
DCOM- 20100818
LR  - 20151119
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Linking)
VI  - 28
IP  - 22
DP  - 2010 Aug 1
TI  - Chemotherapy-phased imatinib pulses improve long-term outcome of adult patients 
      with Philadelphia chromosome-positive acute lymphoblastic leukemia: Northern 
      Italy Leukemia Group protocol 09/00.
PG  - 3644-52
LID - 10.1200/JCO.2010.28.1287 [doi]
AB  - PURPOSE: Short imatinib pulses were added to chemotherapy to improve the 
      long-term survival of adult patients with Philadelphia chromosome (Ph) -positive 
      acute lymphoblastic leukemia (ALL), to optimize complete remission (CR) and 
      stem-cell transplantation (SCT) rates. PATIENTS AND METHODS: Of 94 total patients 
      (age range, 19 to 66 years), 35 represented the control cohort (ie, 
      imatinib-negative [IM-negative] group), and 59 received imatinib 600 mg/d orally 
      for 7 consecutive days (ie, imatinib-positive [IM-positive] group), starting from 
      day 15 of chemotherapy course 1 and from 3 days before chemotherapy during 
      courses 2 to 8. Patients in CR were eligible for allogeneic SCT or, 
      alternatively, for high-dose therapy with autologous SCT followed by long-term 
      maintenance with intermittent imatinib. RESULTS: CR and SCT rates were greater in 
      the IM-positive group (CR: 92% v 80.5%; P = .08; allogeneic SCT: 63% v 39%; P = 
      .041). At a median observation time of 5 years (range, 0.6 to 9.2 years), 22 
      patients in the IM-positive group versus five patients in the IM-negative group 
      were alive in first CR (P = .037). Patients in the IM-positive group had 
      significantly greater overall and disease-free survival probabilities (overall: 
      0.38 v 0.23; P = .009; disease free: 0.39 v 0.25; P = .044) and a lower incidence 
      of relapse (P = .005). SCT-related mortality was 28% (ie, 15 of 54 patients), and 
      postgraft survival probability was 0.46 overall. CONCLUSION: This imatinib-based 
      protocol improved long-term outcome of adult patients with Ph-positive ALL. With 
      SCT, post-transplantation mortality and relapse remain the major hindrance to 
      additional therapeutic improvement. Additional intensification of imatinib 
      therapy should warrant a better molecular response and clinical outcome, both in 
      patients selected for SCT and in those unable to undergo this procedure.
FAU - Bassan, Renato
AU  - Bassan R
AD  - U.S.C. Ematologia, Ospedali Riuniti, Bergamo, Italy. 
      rbassan@ospedaliriuniti.bergamo.it
FAU - Rossi, Giuseppe
AU  - Rossi G
FAU - Pogliani, Enrico M
AU  - Pogliani EM
FAU - Di Bona, Eros
AU  - Di Bona E
FAU - Angelucci, Emanuele
AU  - Angelucci E
FAU - Cavattoni, Irene
AU  - Cavattoni I
FAU - Lambertenghi-Deliliers, Giorgio
AU  - Lambertenghi-Deliliers G
FAU - Mannelli, Francesco
AU  - Mannelli F
FAU - Levis, Alessandro
AU  - Levis A
FAU - Ciceri, Fabio
AU  - Ciceri F
FAU - Mattei, Daniele
AU  - Mattei D
FAU - Borlenghi, Erika
AU  - Borlenghi E
FAU - Terruzzi, Elisabetta
AU  - Terruzzi E
FAU - Borghero, Carlo
AU  - Borghero C
FAU - Romani, Claudio
AU  - Romani C
FAU - Spinelli, Orietta
AU  - Spinelli O
FAU - Tosi, Manuela
AU  - Tosi M
FAU - Oldani, Elena
AU  - Oldani E
FAU - Intermesoli, Tamara
AU  - Intermesoli T
FAU - Rambaldi, Alessandro
AU  - Rambaldi A
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100706
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 0 (Benzamides)
RN  - 0 (Piperazines)
RN  - 0 (Pyrimidines)
RN  - 8A1O1M485B (Imatinib Mesylate)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Benzamides
MH  - Disease-Free Survival
MH  - Drug Administration Schedule
MH  - Female
MH  - Humans
MH  - Imatinib Mesylate
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - Piperazines/*administration & dosage
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy/mortality
MH  - Prognosis
MH  - Pyrimidines/*administration & dosage
MH  - Remission Induction
MH  - Stem Cell Transplantation
EDAT- 2010/07/08 06:00
MHDA- 2010/08/19 06:00
CRDT- 2010/07/08 06:00
PHST- 2010/07/08 06:00 [entrez]
PHST- 2010/07/08 06:00 [pubmed]
PHST- 2010/08/19 06:00 [medline]
AID - JCO.2010.28.1287 [pii]
AID - 10.1200/JCO.2010.28.1287 [doi]
PST - ppublish
SO  - J Clin Oncol. 2010 Aug 1;28(22):3644-52. doi: 10.1200/JCO.2010.28.1287. Epub 2010 
      Jul 6.