The evolving role of chemotherapy and hematopoietic cell transplants in Ph-positive acute lymphoblastic leukemia in adults Journal Article


Authors: Litzow, M. R.; Fielding, A. K.; Luger, S. M.; Paietta, E.; Ofran, Y.; Rowe, J. M.; Goldstone, A. H.; Tallman, M. S.; Lazarus, H. M.
Article Title: The evolving role of chemotherapy and hematopoietic cell transplants in Ph-positive acute lymphoblastic leukemia in adults
Abstract: The introduction of the tyrosine kinase inhibitors (TKI) into the treatment of patients with Ph or BCR-ABL1-positive acute lymphoblastic leukemia has revolutionized the treatment of this poor prognosis acute leukemia. The combination of TKI with chemotherapy has improved response rates and allowed more patients to proceed to allogeneic hematopoietic cell transplant (alloHCT). Older patients have excellent responses to TKI and corticosteroids or in combination with minimal chemotherapy. This raises the question as to whether patients require full-intensity chemotherapy with TKI to achieve molecular remissions. The pediatricians have proposed that cure is achievable without alloHCT in children. These results have suggested that many patients may not require traditional chemotherapy in addition to TKI to achieve remission, and that patients who achieve a negative minimal residual disease state may not require alloHCT. The data in support of these questions is presented here and a suggested future clinical trial design based on these data is proposed.
Keywords: tyrosine kinase inhibitors; arsenic trioxide; retinoic acid; acute promyelocytic leukemia; phase-ii; term-follow-up; imatinib mesylate; allogeneic transplantation; hyper-cvad; b-precursor
Journal Title: Bone Marrow Transplantation
Volume: 52
Issue: 12
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 2017-12-01
Start Page: 1592
End Page: 1598
Language: English
ACCESSION: WOS:000417130300004
DOI: 10.1038/bmt.2017.110
PROVIDER: wos
PUBMED: 28581459
Notes: Review -- Source: Wos
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  1. Martin Stuart Tallman
    396 Tallman