The extent of minimal residual disease reduction after the first 4‐week imatinib therapy determines outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia
BACKGROUND: Previously, the authors demonstrated the positive impact of imatinib on the outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph‐positive ALL). Here, the authors analyzed for risk factors that affect transplantat...
Gespeichert in:
Veröffentlicht in: | Cancer 2009-02, Vol.115 (3), p.561-570 |
---|---|
Hauptverfasser: | , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 570 |
---|---|
container_issue | 3 |
container_start_page | 561 |
container_title | Cancer |
container_volume | 115 |
creator | Lee, Seok Kim, Yoo‐Jin Chung, Nak‐Gyun Lim, Jihyang Lee, Dong‐Gun Kim, Hee‐Je Min, Chang‐Ki Lee, Jong‐Wook Min, Woo‐Sung Kim, Chun‐Choo |
description | BACKGROUND:
Previously, the authors demonstrated the positive impact of imatinib on the outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph‐positive ALL). Here, the authors analyzed for risk factors that affect transplantation outcome, and they focused particularly on the prognostic relevance of minimal residual disease level at each treatment stage.
METHODS:
Fifty‐two patients with newly diagnosed Ph‐positive ALL who completed allogeneic stem cell transplantation following imatinib therapy were enrolled in this study. For minimal residual disease monitoring, 548 marrow samples were analyzed by a real‐time quantitative polymerase chain reaction assay.
RESULTS:
After the first 4‐week imatinib therapy, 11 patients (21.2%) achieved molecular remission, and the remaining 41 patients had a reduction in BCR‐ABL transcript levels (median, 3.21 log) from baseline value. The frequency of achieving a reduction in BCR‐ABL transcript levels of at least 3 log at this stage was 36 (69.2%). Forty‐eight (92.3%) of the 52 patients received stem cell transplantation during first complete remission. With a median follow‐up of 49 months after stem cell transplantation, the 4‐year relapse rate and disease‐free survival rate were 21.2% and 69.8%, respectively. A reduction in BCR‐ABL transcript levels of at least 3 log after the first 4‐week imatinib therapy was identified as the most powerful predictor of lower relapse (12.1% vs 45.1%, P = .011) and better disease‐free survival (82.1% vs 41.7%, P = .009) rates.
CONCLUSIONS:
Prospective assessment of the extent of minimal residual disease reduction after the first 4‐week imatinib therapy may allow the authors to identify subgroups of Ph‐positive ALL transplants at high risk of relapse. Cancer 2009. © 2008 American Cancer Society.
A reduction in BCR‐ABL transcript levels of at least 3 log after the first 4‐week imatinib therapy was identified as the most powerful predictor of transplantation outcome in terms of lower relapse (12.1% vs 45.1%, P = .011) and better disease‐free survival (82.1% vs 41.7%, P = .009) rates in adults with newly diagnosed Philadelphia chromosome‐positive acute lymphoblastic leukemia. If this is verified, it would be interesting to study whether the inclusion of newer tyrosine kinase inhibitors into chemotherapy schedules according to the extent of minimal residual disease reduction at this stage modifies the overall transplantati |
doi_str_mv | 10.1002/cncr.24026 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_66851669</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>20742274</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4246-5aa8d7535bd0ae7c03f5774e9d0f371c1fbff8aaf255550211a73746ba31b89d3</originalsourceid><addsrcrecordid>eNqFkcFu1DAQhiMEokvhwgMgX-BQKcV2nHhzRKtSkCpAqEjcook9JqZOHGyHZW88As-IeBC83RXcwBd77G_-X56_KB4zes4o5c_VpMI5F5Q3d4oVo60sKRP8brGilK7LWlQfT4oHMX7OpeR1db84YS1jshLNqvh1PSDBbwmnRLwho53sCI4EjFYv-aBtRIiYL_SikvUTAZMwkJTbjA0xEfHz-48t4g3JjSm39_u3APOOaMxkVsRI_JKUH3FvAc75TzihVSQmHIlC50gKMMXZwZTg1sRmH724FMnWpoG8G6wDjW4eLBA1BD_6mOWy8-yjTfYrElBLQuJ24zz43kFMWd_hcoOjhYfFPQMu4qPjflp8eHlxvXlVXr29fL15cVUqwUVT1gBrLeuq7jUFlIpWppZSYKupqSRTzPTGrAEMr_OinDGQlRRNDxXr162uTotnB905-C8LxtSNNu7_BxP6JXZNs65Z07T_BTmVgnMpMnh2AFXwMQY03RzynMOuY7Tbh9_tw-9uw8_wk6Pq0o-o_6LHtDPw9AhAVOBMHrqy8Q_HGZVStixz7MBtrcPdPyy7zZvN-4P5b24r0F0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>20742274</pqid></control><display><type>article</type><title>The extent of minimal residual disease reduction after the first 4‐week imatinib therapy determines outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><source>Alma/SFX Local Collection</source><creator>Lee, Seok ; Kim, Yoo‐Jin ; Chung, Nak‐Gyun ; Lim, Jihyang ; Lee, Dong‐Gun ; Kim, Hee‐Je ; Min, Chang‐Ki ; Lee, Jong‐Wook ; Min, Woo‐Sung ; Kim, Chun‐Choo</creator><creatorcontrib>Lee, Seok ; Kim, Yoo‐Jin ; Chung, Nak‐Gyun ; Lim, Jihyang ; Lee, Dong‐Gun ; Kim, Hee‐Je ; Min, Chang‐Ki ; Lee, Jong‐Wook ; Min, Woo‐Sung ; Kim, Chun‐Choo</creatorcontrib><description>BACKGROUND:
Previously, the authors demonstrated the positive impact of imatinib on the outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph‐positive ALL). Here, the authors analyzed for risk factors that affect transplantation outcome, and they focused particularly on the prognostic relevance of minimal residual disease level at each treatment stage.
METHODS:
Fifty‐two patients with newly diagnosed Ph‐positive ALL who completed allogeneic stem cell transplantation following imatinib therapy were enrolled in this study. For minimal residual disease monitoring, 548 marrow samples were analyzed by a real‐time quantitative polymerase chain reaction assay.
RESULTS:
After the first 4‐week imatinib therapy, 11 patients (21.2%) achieved molecular remission, and the remaining 41 patients had a reduction in BCR‐ABL transcript levels (median, 3.21 log) from baseline value. The frequency of achieving a reduction in BCR‐ABL transcript levels of at least 3 log at this stage was 36 (69.2%). Forty‐eight (92.3%) of the 52 patients received stem cell transplantation during first complete remission. With a median follow‐up of 49 months after stem cell transplantation, the 4‐year relapse rate and disease‐free survival rate were 21.2% and 69.8%, respectively. A reduction in BCR‐ABL transcript levels of at least 3 log after the first 4‐week imatinib therapy was identified as the most powerful predictor of lower relapse (12.1% vs 45.1%, P = .011) and better disease‐free survival (82.1% vs 41.7%, P = .009) rates.
CONCLUSIONS:
Prospective assessment of the extent of minimal residual disease reduction after the first 4‐week imatinib therapy may allow the authors to identify subgroups of Ph‐positive ALL transplants at high risk of relapse. Cancer 2009. © 2008 American Cancer Society.
A reduction in BCR‐ABL transcript levels of at least 3 log after the first 4‐week imatinib therapy was identified as the most powerful predictor of transplantation outcome in terms of lower relapse (12.1% vs 45.1%, P = .011) and better disease‐free survival (82.1% vs 41.7%, P = .009) rates in adults with newly diagnosed Philadelphia chromosome‐positive acute lymphoblastic leukemia. If this is verified, it would be interesting to study whether the inclusion of newer tyrosine kinase inhibitors into chemotherapy schedules according to the extent of minimal residual disease reduction at this stage modifies the overall transplantation outcome.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.24026</identifier><identifier>PMID: 19117346</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Abl protein ; Acute lymphatic leukemia ; Adolescent ; Adult ; allogeneic stem cell transplantation ; BCR protein ; Benzamides ; Biological and medical sciences ; Cancer ; Cell survival ; Disease-Free Survival ; Female ; Follow-Up Studies ; Fusion protein ; Humans ; Imatinib ; Imatinib Mesylate ; Male ; Medical sciences ; Middle Aged ; minimal residual disease ; Neoplasm, Residual - diagnosis ; Philadelphia chromosome‐positive acute lymphoblastic leukemia ; Piperazines - therapeutic use ; Polymerase chain reaction ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Prognosis ; Pyrimidines - therapeutic use ; Recurrence ; Remission ; Risk Factors ; Stem Cell Transplantation ; Survival ; Time Factors ; Transcription ; Tumors</subject><ispartof>Cancer, 2009-02, Vol.115 (3), p.561-570</ispartof><rights>Copyright © 2009 American Cancer Society</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4246-5aa8d7535bd0ae7c03f5774e9d0f371c1fbff8aaf255550211a73746ba31b89d3</citedby><cites>FETCH-LOGICAL-c4246-5aa8d7535bd0ae7c03f5774e9d0f371c1fbff8aaf255550211a73746ba31b89d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.24026$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.24026$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21077791$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19117346$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Seok</creatorcontrib><creatorcontrib>Kim, Yoo‐Jin</creatorcontrib><creatorcontrib>Chung, Nak‐Gyun</creatorcontrib><creatorcontrib>Lim, Jihyang</creatorcontrib><creatorcontrib>Lee, Dong‐Gun</creatorcontrib><creatorcontrib>Kim, Hee‐Je</creatorcontrib><creatorcontrib>Min, Chang‐Ki</creatorcontrib><creatorcontrib>Lee, Jong‐Wook</creatorcontrib><creatorcontrib>Min, Woo‐Sung</creatorcontrib><creatorcontrib>Kim, Chun‐Choo</creatorcontrib><title>The extent of minimal residual disease reduction after the first 4‐week imatinib therapy determines outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND:
Previously, the authors demonstrated the positive impact of imatinib on the outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph‐positive ALL). Here, the authors analyzed for risk factors that affect transplantation outcome, and they focused particularly on the prognostic relevance of minimal residual disease level at each treatment stage.
METHODS:
Fifty‐two patients with newly diagnosed Ph‐positive ALL who completed allogeneic stem cell transplantation following imatinib therapy were enrolled in this study. For minimal residual disease monitoring, 548 marrow samples were analyzed by a real‐time quantitative polymerase chain reaction assay.
RESULTS:
After the first 4‐week imatinib therapy, 11 patients (21.2%) achieved molecular remission, and the remaining 41 patients had a reduction in BCR‐ABL transcript levels (median, 3.21 log) from baseline value. The frequency of achieving a reduction in BCR‐ABL transcript levels of at least 3 log at this stage was 36 (69.2%). Forty‐eight (92.3%) of the 52 patients received stem cell transplantation during first complete remission. With a median follow‐up of 49 months after stem cell transplantation, the 4‐year relapse rate and disease‐free survival rate were 21.2% and 69.8%, respectively. A reduction in BCR‐ABL transcript levels of at least 3 log after the first 4‐week imatinib therapy was identified as the most powerful predictor of lower relapse (12.1% vs 45.1%, P = .011) and better disease‐free survival (82.1% vs 41.7%, P = .009) rates.
CONCLUSIONS:
Prospective assessment of the extent of minimal residual disease reduction after the first 4‐week imatinib therapy may allow the authors to identify subgroups of Ph‐positive ALL transplants at high risk of relapse. Cancer 2009. © 2008 American Cancer Society.
A reduction in BCR‐ABL transcript levels of at least 3 log after the first 4‐week imatinib therapy was identified as the most powerful predictor of transplantation outcome in terms of lower relapse (12.1% vs 45.1%, P = .011) and better disease‐free survival (82.1% vs 41.7%, P = .009) rates in adults with newly diagnosed Philadelphia chromosome‐positive acute lymphoblastic leukemia. If this is verified, it would be interesting to study whether the inclusion of newer tyrosine kinase inhibitors into chemotherapy schedules according to the extent of minimal residual disease reduction at this stage modifies the overall transplantation outcome.</description><subject>Abl protein</subject><subject>Acute lymphatic leukemia</subject><subject>Adolescent</subject><subject>Adult</subject><subject>allogeneic stem cell transplantation</subject><subject>BCR protein</subject><subject>Benzamides</subject><subject>Biological and medical sciences</subject><subject>Cancer</subject><subject>Cell survival</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fusion protein</subject><subject>Humans</subject><subject>Imatinib</subject><subject>Imatinib Mesylate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>minimal residual disease</subject><subject>Neoplasm, Residual - diagnosis</subject><subject>Philadelphia chromosome‐positive acute lymphoblastic leukemia</subject><subject>Piperazines - therapeutic use</subject><subject>Polymerase chain reaction</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</subject><subject>Prognosis</subject><subject>Pyrimidines - therapeutic use</subject><subject>Recurrence</subject><subject>Remission</subject><subject>Risk Factors</subject><subject>Stem Cell Transplantation</subject><subject>Survival</subject><subject>Time Factors</subject><subject>Transcription</subject><subject>Tumors</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFu1DAQhiMEokvhwgMgX-BQKcV2nHhzRKtSkCpAqEjcook9JqZOHGyHZW88As-IeBC83RXcwBd77G_-X56_KB4zes4o5c_VpMI5F5Q3d4oVo60sKRP8brGilK7LWlQfT4oHMX7OpeR1db84YS1jshLNqvh1PSDBbwmnRLwho53sCI4EjFYv-aBtRIiYL_SikvUTAZMwkJTbjA0xEfHz-48t4g3JjSm39_u3APOOaMxkVsRI_JKUH3FvAc75TzihVSQmHIlC50gKMMXZwZTg1sRmH724FMnWpoG8G6wDjW4eLBA1BD_6mOWy8-yjTfYrElBLQuJ24zz43kFMWd_hcoOjhYfFPQMu4qPjflp8eHlxvXlVXr29fL15cVUqwUVT1gBrLeuq7jUFlIpWppZSYKupqSRTzPTGrAEMr_OinDGQlRRNDxXr162uTotnB905-C8LxtSNNu7_BxP6JXZNs65Z07T_BTmVgnMpMnh2AFXwMQY03RzynMOuY7Tbh9_tw-9uw8_wk6Pq0o-o_6LHtDPw9AhAVOBMHrqy8Q_HGZVStixz7MBtrcPdPyy7zZvN-4P5b24r0F0</recordid><startdate>20090201</startdate><enddate>20090201</enddate><creator>Lee, Seok</creator><creator>Kim, Yoo‐Jin</creator><creator>Chung, Nak‐Gyun</creator><creator>Lim, Jihyang</creator><creator>Lee, Dong‐Gun</creator><creator>Kim, Hee‐Je</creator><creator>Min, Chang‐Ki</creator><creator>Lee, Jong‐Wook</creator><creator>Min, Woo‐Sung</creator><creator>Kim, Chun‐Choo</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20090201</creationdate><title>The extent of minimal residual disease reduction after the first 4‐week imatinib therapy determines outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia</title><author>Lee, Seok ; Kim, Yoo‐Jin ; Chung, Nak‐Gyun ; Lim, Jihyang ; Lee, Dong‐Gun ; Kim, Hee‐Je ; Min, Chang‐Ki ; Lee, Jong‐Wook ; Min, Woo‐Sung ; Kim, Chun‐Choo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4246-5aa8d7535bd0ae7c03f5774e9d0f371c1fbff8aaf255550211a73746ba31b89d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abl protein</topic><topic>Acute lymphatic leukemia</topic><topic>Adolescent</topic><topic>Adult</topic><topic>allogeneic stem cell transplantation</topic><topic>BCR protein</topic><topic>Benzamides</topic><topic>Biological and medical sciences</topic><topic>Cancer</topic><topic>Cell survival</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fusion protein</topic><topic>Humans</topic><topic>Imatinib</topic><topic>Imatinib Mesylate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>minimal residual disease</topic><topic>Neoplasm, Residual - diagnosis</topic><topic>Philadelphia chromosome‐positive acute lymphoblastic leukemia</topic><topic>Piperazines - therapeutic use</topic><topic>Polymerase chain reaction</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</topic><topic>Prognosis</topic><topic>Pyrimidines - therapeutic use</topic><topic>Recurrence</topic><topic>Remission</topic><topic>Risk Factors</topic><topic>Stem Cell Transplantation</topic><topic>Survival</topic><topic>Time Factors</topic><topic>Transcription</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Seok</creatorcontrib><creatorcontrib>Kim, Yoo‐Jin</creatorcontrib><creatorcontrib>Chung, Nak‐Gyun</creatorcontrib><creatorcontrib>Lim, Jihyang</creatorcontrib><creatorcontrib>Lee, Dong‐Gun</creatorcontrib><creatorcontrib>Kim, Hee‐Je</creatorcontrib><creatorcontrib>Min, Chang‐Ki</creatorcontrib><creatorcontrib>Lee, Jong‐Wook</creatorcontrib><creatorcontrib>Min, Woo‐Sung</creatorcontrib><creatorcontrib>Kim, Chun‐Choo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Seok</au><au>Kim, Yoo‐Jin</au><au>Chung, Nak‐Gyun</au><au>Lim, Jihyang</au><au>Lee, Dong‐Gun</au><au>Kim, Hee‐Je</au><au>Min, Chang‐Ki</au><au>Lee, Jong‐Wook</au><au>Min, Woo‐Sung</au><au>Kim, Chun‐Choo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The extent of minimal residual disease reduction after the first 4‐week imatinib therapy determines outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2009-02-01</date><risdate>2009</risdate><volume>115</volume><issue>3</issue><spage>561</spage><epage>570</epage><pages>561-570</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND:
Previously, the authors demonstrated the positive impact of imatinib on the outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph‐positive ALL). Here, the authors analyzed for risk factors that affect transplantation outcome, and they focused particularly on the prognostic relevance of minimal residual disease level at each treatment stage.
METHODS:
Fifty‐two patients with newly diagnosed Ph‐positive ALL who completed allogeneic stem cell transplantation following imatinib therapy were enrolled in this study. For minimal residual disease monitoring, 548 marrow samples were analyzed by a real‐time quantitative polymerase chain reaction assay.
RESULTS:
After the first 4‐week imatinib therapy, 11 patients (21.2%) achieved molecular remission, and the remaining 41 patients had a reduction in BCR‐ABL transcript levels (median, 3.21 log) from baseline value. The frequency of achieving a reduction in BCR‐ABL transcript levels of at least 3 log at this stage was 36 (69.2%). Forty‐eight (92.3%) of the 52 patients received stem cell transplantation during first complete remission. With a median follow‐up of 49 months after stem cell transplantation, the 4‐year relapse rate and disease‐free survival rate were 21.2% and 69.8%, respectively. A reduction in BCR‐ABL transcript levels of at least 3 log after the first 4‐week imatinib therapy was identified as the most powerful predictor of lower relapse (12.1% vs 45.1%, P = .011) and better disease‐free survival (82.1% vs 41.7%, P = .009) rates.
CONCLUSIONS:
Prospective assessment of the extent of minimal residual disease reduction after the first 4‐week imatinib therapy may allow the authors to identify subgroups of Ph‐positive ALL transplants at high risk of relapse. Cancer 2009. © 2008 American Cancer Society.
A reduction in BCR‐ABL transcript levels of at least 3 log after the first 4‐week imatinib therapy was identified as the most powerful predictor of transplantation outcome in terms of lower relapse (12.1% vs 45.1%, P = .011) and better disease‐free survival (82.1% vs 41.7%, P = .009) rates in adults with newly diagnosed Philadelphia chromosome‐positive acute lymphoblastic leukemia. If this is verified, it would be interesting to study whether the inclusion of newer tyrosine kinase inhibitors into chemotherapy schedules according to the extent of minimal residual disease reduction at this stage modifies the overall transplantation outcome.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>19117346</pmid><doi>10.1002/cncr.24026</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0008-543X |
ispartof | Cancer, 2009-02, Vol.115 (3), p.561-570 |
issn | 0008-543X 1097-0142 |
language | eng |
recordid | cdi_proquest_miscellaneous_66851669 |
source | MEDLINE; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; Wiley Online Library (Open Access Collection); Alma/SFX Local Collection |
subjects | Abl protein Acute lymphatic leukemia Adolescent Adult allogeneic stem cell transplantation BCR protein Benzamides Biological and medical sciences Cancer Cell survival Disease-Free Survival Female Follow-Up Studies Fusion protein Humans Imatinib Imatinib Mesylate Male Medical sciences Middle Aged minimal residual disease Neoplasm, Residual - diagnosis Philadelphia chromosome‐positive acute lymphoblastic leukemia Piperazines - therapeutic use Polymerase chain reaction Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy Prognosis Pyrimidines - therapeutic use Recurrence Remission Risk Factors Stem Cell Transplantation Survival Time Factors Transcription Tumors |
title | The extent of minimal residual disease reduction after the first 4‐week imatinib therapy determines outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome‐positive acute lymphoblastic leukemia |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T15%3A32%3A19IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20extent%20of%20minimal%20residual%20disease%20reduction%20after%20the%20first%204%E2%80%90week%20imatinib%20therapy%20determines%20outcome%20of%20allogeneic%20stem%20cell%20transplantation%20in%20adults%20with%20Philadelphia%20chromosome%E2%80%90positive%20acute%20lymphoblastic%20leukemia&rft.jtitle=Cancer&rft.au=Lee,%20Seok&rft.date=2009-02-01&rft.volume=115&rft.issue=3&rft.spage=561&rft.epage=570&rft.pages=561-570&rft.issn=0008-543X&rft.eissn=1097-0142&rft.coden=CANCAR&rft_id=info:doi/10.1002/cncr.24026&rft_dat=%3Cproquest_cross%3E20742274%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=20742274&rft_id=info:pmid/19117346&rfr_iscdi=true |