当前位置： SCI文献检索 > LEUKEMIA期刊下所有文献 > Randomized comparison of prophylactic and minimal residual disease-triggered imatinib after allogeneic stem cell transplantation for BCR-ABL1-positive acute lymphoblastic leukemia.

Randomized comparison of prophylactic and minimal residual disease-triggered imatinib after allogeneic stem cell transplantation for BCR-ABL1-positive acute lymphoblastic leukemia.

Abstract：

:Minimal residual disease (MRD) after allogeneic stem cell transplantation (SCT) for Ph+ acute lymphoblastic leukemia (ALL) is predictive of relapse. Imatinib administration subsequent to SCT may prevent relapse, but the role of scheduling and its impact on outcome are not known. In a prospective, randomized multicenter trial, we compared the tolerability and efficacy of post-transplant imatinib administered either prophylactically (arm A; n=26) or following detection of MRD (arm B; n=29). Prophylactic imatinib significantly reduced the incidence of molecular recurrence after SCT compared with MRD-triggered imatinib (40% vs 69%; P=0.046). Median duration of PCR negativity was 26.5 and 6.8 months, respectively (P=0.065). Five-year survival in both interventional groups was high (80 and 74.5%), despite premature discontinuation of imatinib in the majority of patients because of poor tolerability. Relapse probability was significantly higher in patients who became MRD positive (P=0.017). In conclusion, post-transplant imatinib results in a low relapse rate, durable remissions and excellent long-term outcome in patients with BCR-ABL1-positive ALL irrespective of whether it is given prophylactically or MRD-triggered. Reappearance of BCR-ABL1 transcripts early after SCT or at higher levels identifies a small subset of patients who do not benefit sufficiently from imatinib, and in whom alternative approaches should be explored.

journal_name

Leukemia

journal_title

Leukemia

authors

Pfeifer H,Wassmann B,Bethge W,Dengler J,Bornhäuser M,Stadler M,Beelen D,Vucinic V,Burmeister T,Stelljes M,Faul C,Dreger P,Kiani A,Schäfer-Eckart K,Schwerdtfeger R,Lange E,Kubuschok B,Horst HA,Gramatzki M,Brück P,S

doi

10.1038/leu.2012.352

subject

Has Abstract

pub_date

2013-06-01 00:00:00

pages

1254-62

issue

6

eissn

0887-6924

issn

1476-5551

pii

leu2012352

journal_volume

27

pub_type

杂志文章,多中心研究,随机对照试验

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