Ovid: Welcome to Ovid

Long-term follow-up of imatinib in pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia: Children's Oncology Group Study AALL0031.
Schultz, K R 1; Carroll, A 2; Heerema, N A 3; Bowman, W P 4; Aledo, A 5; Slayton, W B 6; Sather, H 7; Devidas, M 8; Zheng, H W 9; Davies, S M 10; Gaynon, P S 11; Trigg, M 12; Rutledge, R 13; Jorstad, D 14; Winick, N 15; Borowitz, M J 16; Hunger, S P 9; Carroll, W L 17; Camitta, B 14; from the Children's Oncology Group
[Article] Leukemia. 28(7):1467-1471, July 2014.

(Format: HTML, PDF)

: We previously reported preliminary findings that post induction imatinib mesylate (340 mg/m2/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.