Long-term follow-up of imatinib in pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia: Children's oncology group study AALL0031

K. R. Schultz, A. Carroll, N. A. Heerema, W. P. Bowman, A. Aledo, W. B. Slayton, H. Sather, M. Devidas, H. W. Zheng, S. M. Davies, P. S. Gaynon, M. Trigg, R. Rutledge, D. Jorstad, N. Winick, M. J. Borowitz, S. P. Hunger, W. L. Carroll, B. Camitta

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218 Scopus citations

Abstract

We previously reported preliminary findings that post induction imatinib mesylate (340 mg/m 2/day), in combination with intensive chemotherapy, resulted in outcomes similar to blood and marrow transplant (BMT) for pediatric patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). We now report 5-year outcomes of imatinib plus intensive chemotherapy in 91 children (1-21 years) with and without allogeneic BMT (N=91). We explore the impacts of additional chromosomal abnormalities and minimal residual disease (MRD) by flow cytometry on outcomes. The 5-year disease-free survival was similar for Cohort 5 patients, treated with chemotherapy plus imatinib (70%±12%, n=28), sibling donor BMT patients (65%±11%, n=21) and unrelated donor BMT patients (59±15%; P=0.60, n=13). Patients with additional cytogenetic abnormalities had worse outcomes (P=0.05). End induction (pre-imatinib) MRD was not prognostic for Cohort 5 or allogeneic BMT patients, although limited by small numbers. The re-induction rate following relapse was similar to other higher-risk ALL groups. Longer-term follow-up confirms our initial observation of substantially good outcomes for children and adolescents with Ph+ ALL treated with imatinib plus intensive chemotherapy with no advantage for allogeneic BMT.

Original languageEnglish
Pages (from-to)1467-1471
Number of pages5
JournalLeukemia
Volume28
Issue number7
DOIs
StatePublished - Jul 2014

Keywords

  • Philadelphia chromosome
  • acute lymphoblastic leukemia
  • blood and marrow transplantation
  • event-free survival
  • imatinib mesylate
  • toxicity

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    Schultz, K. R., Carroll, A., Heerema, N. A., Bowman, W. P., Aledo, A., Slayton, W. B., Sather, H., Devidas, M., Zheng, H. W., Davies, S. M., Gaynon, P. S., Trigg, M., Rutledge, R., Jorstad, D., Winick, N., Borowitz, M. J., Hunger, S. P., Carroll, W. L., & Camitta, B. (2014). Long-term follow-up of imatinib in pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia: Children's oncology group study AALL0031. Leukemia, 28(7), 1467-1471. https://doi.org/10.1038/leu.2014.30