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Title: Tyrosine kinase inhibitors improve long-term outcome of allogeneic hematopoietic stem cell transplantation for adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia
Author: Brissot, Eolia
Labopin, Myriam
Beckers, Marielle M.
Socié, Gérard
Rambaldi, Alessandro
Volin, Liisa
Finke, Jürgen
Lenhoff, Stig
Kröger, Nicolaus
Ossenkoppele, Gert J.
Craddock, Charles F.
Yakoub-Agha, Ibrahim
Gürman, Günhan
Russell, Nigel H.
Aljurf, Mahmoud
Potter, Michael N.
Nagler, Armon
Ottmann, Oliver
Cornelissen, Jan J.
Esteve Reyner, Jordi
Mohty, Mohamad
Keywords: Leucèmia limfocítica crònica
Cèl·lules mare
Inhibidors enzimàtics
Chronic lymphocytic leukemia
Stem cells
Enzyme inhibitors
Issue Date: Mar-2015
Publisher: Ferrata Storti Foundation
Abstract: This study aimed to determine the impact of tyrosine kinase inhibitors given pre- and post-allogeneic stem cell transplantation on long-term outcome of patients allografted for Philadelphia chromosome-positive acute lymphoblastic leukemia. This retrospective analysis from the EBMT Acute Leukemia Working Party included 473 de novo Philadelphia chromosome-positive acute lymphoblastic leukemia patients in first complete remission who underwent an allogeneic stem cell transplantation using a human leukocyte antigen-identical sibling or human leukocyte antigen-matched unrelated donor between 2000 and 2010. Three hundred and ninety patients received tyrosine kinase inhibitors before transplant, 329 at induction and 274 at consolidation. Kaplan-Meier estimates of leukemia-free survival, overall survival, cumulative incidences of relapse incidence, and non-relapse mortality at five years were 38%, 46%, 36% and 26%, respectively. In multivariate analysis, tyrosine-kinase inhibitors given before allogeneic stem cell transplantation was associated with a better overall survival (HR=0.68; P=0.04) and was associated with lower relapse incidence (HR=0.5; P=0.01). In the post-transplant period, multivariate analysis identified prophylactic tyrosine-kinase inhibitor administration to be a significant factor for improved leukemia-free survival (HR=0.44; P=0.002) and overall survival (HR=0.42; P=0.004), and a lower relapse incidence (HR=0.40; P=0.01). Over the past decade, administration of tyrosine kinase inhibitors before allogeneic stem cell transplantation has significantly improved the long-term allogeneic stem cell transplantation outcome of adult Philadelphia chromosome-positive acute lymphoblastic leukemia. Prospective studies will be of great interest to further confirm the potential benefit of the prophylactic use of tyrosine kinase inhibitors in the post-transplant setting.
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It is part of: Haematologica, 2015, vol. 100, num. 3, p. 392-399
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ISSN: 0390-6078
Appears in Collections:Articles publicats en revistes (Medicina)

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