PMID- 22682059
OWN - NLM
STAT- MEDLINE
DCOM- 20121220
LR  - 20211021
IS  - 1756-8722 (Electronic)
IS  - 1756-8722 (Linking)
VI  - 5
DP  - 2012 Jun 8
TI  - Administration of imatinib after allogeneic hematopoietic stem cell 
      transplantation may improve disease-free survival for patients with Philadelphia 
      chromosome-positive acute lymphobla stic leukemia.
PG  - 29
LID - 10.1186/1756-8722-5-29 [doi]
AB  - BACKGROUND: Maintenance therapy with imatinib during the post-transplant period 
      has been used for patients with Philadelphia chromosome-positive acute 
      lymphoblastic leukemia (Ph + ALL); however, its efficacy has not been 
      demonstrated. A study was designed to investigate the safety of imatinib and its 
      efficacy in preventing hematological relapse and improving disease-free survival 
      (DFS) when administered after allogeneic hematopoietic stem cell transplantation 
      (allo-HCT). METHODS: Patients with Ph + ALL that received allo-HCT were enrolled 
      in the study. Real-time quantitative reverse-transcription polymerase chain 
      reaction (qRT-PCR) was used to detect BCR-ABL transcript levels. Imatinib therapy 
      was initiated if patient neutrophil counts were > 1.0 x 10(9)/L and platelet 
      counts were > 50.0 x 10(9)/L, or if they displayed either elevated BCR-ABL 
      transcript levels in two consecutive tests, or a BCR-ABL transcript level >/= 
      10(-2) after initial engraftment. Patients receiving imatinib after relapse were 
      assigned to the non-imatinib group. The imatinib treatment was scheduled for 3-12 
      months, until BCR-ABL transcript levels were negative at least for three 
      consecutive tests or complete molecular remission was sustained for at least 3 
      months. RESULTS: A total of 82 patients were enrolled. Sixty-two patients 
      initiated imatinib therapy post-HCT. Imatinib therapy was initiated at a median 
      time of 70 days post-HCT. Grade 3-4 adverse events (AEs) occurred in 17.7% of 
      patients. Ten patients (16.1%) terminated imatinib therapy owing to AEs. Among 
      the patients in imatinib and non-imatinib groups, the estimated 5-year relapse 
      rate was 10.2% and 33.1% (p = 0.016), and the 5-year probability of DFS was 81.5% 
      and 33.5% (p = 0.000) with the median follow-up of 31 months (range, 2.5-76 
      months) and 24.5 months (range, 4-72 months), respectively. Multivariate analysis 
      identified imatinib maintenance therapy post-HCT as an independent prognostic 
      factor for DFS (p = 0.000, hazard ratio [HR] =4.8) and OS (p = 0.000, HR = 6.2). 
      CONCLUSIONS: These results indicate that relapse rate can be reduced and DFS may 
      be improved in Ph + ALL patients with imatinib maintenance therapy after HCT. 
      BCR-ABLmonitoring by qRT-PCR can guide maintenance therapy with imatinib 
      including initiation time and treatment duration after allo-HCT.
FAU - Chen, Huan
AU  - Chen H
AD  - Peking University People's Hospital, Peking University Institute of Hematology, 
      Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, PR 
      China.
FAU - Liu, Kai-yan
AU  - Liu KY
FAU - Xu, Lan-ping
AU  - Xu LP
FAU - Liu, Dai-hong
AU  - Liu DH
FAU - Chen, Yu-hong
AU  - Chen YH
FAU - Zhao, Xiang-yu
AU  - Zhao XY
FAU - Han, Wei
AU  - Han W
FAU - Zhang, Xiao-hui
AU  - Zhang XH
FAU - Wang, Yu
AU  - Wang Y
FAU - Zhang, Yuan-yuan
AU  - Zhang YY
FAU - Qin, Ya-zhen
AU  - Qin YZ
FAU - Liu, Yan-rong
AU  - Liu YR
FAU - Huang, Xiao-jun
AU  - Huang XJ
LA  - eng
PT  - Clinical Trial, Phase II
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120608
PL  - England
TA  - J Hematol Oncol
JT  - Journal of hematology & oncology
JID - 101468937
RN  - 0 (Benzamides)
RN  - 0 (Piperazines)
RN  - 0 (Pyrimidines)
RN  - 8A1O1M485B (Imatinib Mesylate)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Benzamides
MH  - Child
MH  - Child, Preschool
MH  - Combined Modality Therapy
MH  - Female
MH  - Graft vs Host Disease
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Imatinib Mesylate
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/*mortality/therapy
MH  - Neoplasm, Residual/*mortality/therapy
MH  - *Philadelphia Chromosome
MH  - Piperazines/*therapeutic use
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/*mortality/therapy
MH  - Pyrimidines/*therapeutic use
MH  - Survival Rate
MH  - Transplantation, Homologous
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC3407007
EDAT- 2012/06/12 06:00
MHDA- 2012/12/21 06:00
PMCR- 2012/06/08
CRDT- 2012/06/12 06:00
PHST- 2012/03/23 00:00 [received]
PHST- 2012/06/08 00:00 [accepted]
PHST- 2012/06/12 06:00 [entrez]
PHST- 2012/06/12 06:00 [pubmed]
PHST- 2012/12/21 06:00 [medline]
PHST- 2012/06/08 00:00 [pmc-release]
AID - 1756-8722-5-29 [pii]
AID - 10.1186/1756-8722-5-29 [doi]
PST - epublish
SO  - J Hematol Oncol. 2012 Jun 8;5:29. doi: 10.1186/1756-8722-5-29.