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New therapies and gene target advance the treatment and understanding of hard-to-treat leukemias
Date:12/6/2010

induction chemotherapy alone does not produce prolonged remissions. Therefore, an allogeneic stem cell transplant, in which a patient receives stem cells from a sibling or unrelated matched donor, is often recommended after the first complete remission.

In 1993 researchers from the National Cancer Research Institute in the United Kingdom and the Eastern Cooperative Oncology Group in the United States initiated a study to evaluate whether allogeneic stem cell transplant is an effective treatment option for adult patients with Ph+ ALL. In this study, 266 patients received two phases of induction chemotherapy followed by an allogeneic stem cell transplant ("pre-imatinib" arm). Following the availability of imatinib, a targeted BCR-ABL inhibitor, the purpose of the study was modified in 2003 to include and evaluate the use of imatinib as part of consolidation therapy prior to an allogeneic stem cell transplant ("late-imatinib" arm) or as part of standard induction therapy prior to the transplant ("early-imatinib" arm). Results from the pre-imatinib cohort (Fielding, Blood 2009) were then used as a benchmark for use of imatinib in patients with Ph+ ALL.

In the late-imatinib arm of the study, 86 patients received imatinib 600 mg a day as part of consolidation therapy prior to undergoing an allogeneic stem cell transplant following two induction chemotherapy regimens. Those in the early-imatinib arm (89 patients) were given imatinib 600 mg earlier as part of the second chemotherapy induction phase prior to the allogeneic stem cell transplant. All patients who received an allogeneic stem cell transplant in the study were given imatinib for two years post-transplant. If a transplant was not feasible for any reason, imatinib could be given as a maintenance therapy for two years.

Results from this study, the largest international study of patients with Ph+ ALL evaluating allogeneic stem cell transplantation (control group) and the use of im
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Contact: Lindsey Love
llove@hematology.org
540-538-9326
American Society of Hematology
Source:Eurekalert

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