Imatinib and methylprednisolone alternated with chemotherapy improve the outcome of elderly patients with Philadelphia-positive acute lymphoblastic leukemia: results of the GRAALL AFR09 study
| Autor: | C. Fohrer, Anne Sonet, Frédéric Garban, Emmanuel Raffoux, Véronique Lhéritier, S. Cailleres, Chrystele Bilhou-Nabera, Patrice Berthaud, Oumedaly Reman, Hervé Dombret, M C Béné, Xavier Thomas, Viviane Dubruille, Stéphane Darre, Agnès Buzyn, Pascal Turlure, M. Delain, O. Legrand, Eric Delabesse, Serge Bologna, P. Raby, André Delannoy, D. Coso, F. Rigal-Huguet, Sylvie Castaigne, Françoise Isnard |
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| Rok vydání: | 2006 |
| Předmět: |
Cancer Research
medicine.medical_specialty medicine.medical_treatment Philadelphia chromosome Methylprednisolone Gastroenterology Disease-Free Survival Piperazines Refractory hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Philadelphia Chromosome Aged Chemotherapy Hematology business.industry Induction chemotherapy Imatinib Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Surgery Pyrimidines Treatment Outcome Imatinib mesylate Oncology Benzamides Imatinib Mesylate business Stem Cell Transplantation medicine.drug |
| Zdroj: | Leukemia. 20:1526-1532 |
| ISSN: | 1476-5551 0887-6924 |
| DOI: | 10.1038/sj.leu.2404320 |
| Popis: | Acute lymphoblastic leukemia ( ALL) in the elderly is characterized by its ominous prognosis. On the other hand, imatinib has demonstrated remarkable, although transient, activity in relapsed and refractory Philadelphia-positive acute lymphoblastic leukemia (Ph+ALL), which prompted us to assess the use of imatinib in previously untreated elderly patients. ALL patients aged 55 years or older were given steroids during 1 week. Ph+ve cases were then offered a chemotherapy-based induction followed by a consolidation phase with imatinib and steroids during 2 months. Patients in complete response (CR) after consolidation were given 10 maintenance blocks of alternating chemotherapy, including two additional 2-month blocks of imatinib. Thirty patients were included in this study and are compared with 21 historical controls. Out of 29 assessable patients, 21 (72%, confidence interval (CI): 53 - 87%) were in CR after induction chemotherapy vs 6/21 (29%, CI: 11 - 52%) in controls (P = 0.003). Five additional CRs were obtained after salvage with imatinib and four after salvage with additional chemotherapy in the control group. Overall survival ( OS) is 66% at 1 year vs 43% in the control group ( P = 0.005). The 1-year relapse-free survival is 58 vs 11% ( P = 0.0003). The use of imatinib in elderly patients with Ph+ ALL is very likely to improve outcome, including OS. |
| Databáze: | OpenAIRE |
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