The role of ponatinib in adult BCR-ABL1 positive acute lymphoblastic leukemia after allogeneic transplantation: a real-life retrospective multicenter study

Autor: Uros Markovic, Ernesto Vigna, Francesco Grimaldi, Giulia Palazzo, Antonio M. Risitano, Massimo Martino, Maria Cristina Pirosa, Giuseppe Milone, Stefania Stella, Giovanni Pisapia, Angelo Curto Pelle, Raffaele Palmieri, Luca Scalise, Francesco Di Raimondo, Stefania Tringali, Salvatore Leotta, Giulio Antonio Milone, Valerio Leotta, Fausto Palmieri, Paola Carluccio, Mary Ann Di Giorgio, Giorgina Specchia, Anna Bulla, Mario Annunziata
Rok vydání: 2021
Předmět:
Male
bcr-abl
Fusion Proteins
bcr-abl
Salvage therapy
Tyrosine-kinase inhibitor
chemistry.chemical_compound
0302 clinical medicine
Recurrence
hemic and lymphatic diseases
Secondary Prevention
Philadelphia Chromosome
Adjuvant
Ph’+acute lymphoblastic leukemia
Hematology
Ponatinib
Hematopoietic Stem Cell Transplantation
Imidazoles
General Medicine
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Combined Modality Therapy
Pyridazines
Italy
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Acute Disease
Cohort
Toxicity
Female
Homologous
Adult
medicine.medical_specialty
Allogeneic transplantation
medicine.drug_class
Chemoprevention
Young Adult
03 medical and health sciences
Internal medicine
medicine
Chemotherapy
Humans
Transplantation
Homologous
Retrospective Studies
Salvage Therapy
Transplantation
business.industry
Fusion Proteins
Survival Analysis
chemistry
business
030215 immunology
Zdroj: Annals of Hematology. 100:1743-1753
ISSN: 1432-0584
0939-5555
Popis: The experience of third-generation tyrosine kinase inhibitor ponatinib treatment in Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph'+ ALL) patients post-allogeneic transplantation is limited. We retrospectively collected data on 25 Ph'+ ALL patients who were started on ponatinib after allogeneic transplantation between July 2015 and July 2019 from nine transplantation centers in Italy. Ponatinib was given in prophylaxis in five (20%), as pre-emptive treatment in seven (28%), and as salvage therapy in thirteen (52%) patients. It was combined with donor leukocyte infusions in ten patients. Half of the patients (12/25) harbored T315I mutation of BCR/ABL1, while in the remaining mutational analysis was negative or not performed. Among the 20 patients who received ponatinib as pre-emptive/salvage treatment, complete molecular response was achieved in 15 (75%) patients. Estimated overall survival at 2-year post-initiation of treatment in the whole cohort was 65% (respectively 60%, 60%, and 78% for the prophylaxis, pre-emptive, and salvage therapy groups). In patients with T315I-positive mutational status, the estimated 2-year survival was 40%. Fourteen patients (56%) experienced toxicity, requiring temporary or definitive suspension of treatment. In conclusion, treatment of Ph'+ ALL patients with ponatinib after transplantation is effective, although the question of adequate drug dose and treatment duration remains unanswered.
Databáze: OpenAIRE
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