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Tyrosine kinase inhibitor prophylaxis after transplant for Philadelphia chromosome‐positive acute lymphoblastic leukemia

Tyrosine kinase inhibitor (TKI) administration after allogeneic hematopoietic stem cell transplantation (HSCT) may carry a survival benefit in Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph+ ALL). Therefore, we investigated whether TKI prophylaxis for negative‐minimal residual dis...

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Autores principales: Akahoshi, Yu, Nishiwaki, Satoshi, Mizuta, Shuichi, Ohashi, Kazuteru, Uchida, Naoyuki, Tanaka, Masatsugu, Fukuda, Takahiro, Ozawa, Yukiyasu, Takahashi, Satoshi, Onizuka, Makoto, Shiratori, Souichi, Nakamae, Hirohisa, Kanda, Yoshinobu, Ichinohe, Tatsuo, Atsuta, Yoshiko, Kako, Shinichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778639/
https://www.ncbi.nlm.nih.gov/pubmed/31402561
http://dx.doi.org/10.1111/cas.14167
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author Akahoshi, Yu
Nishiwaki, Satoshi
Mizuta, Shuichi
Ohashi, Kazuteru
Uchida, Naoyuki
Tanaka, Masatsugu
Fukuda, Takahiro
Ozawa, Yukiyasu
Takahashi, Satoshi
Onizuka, Makoto
Shiratori, Souichi
Nakamae, Hirohisa
Kanda, Yoshinobu
Ichinohe, Tatsuo
Atsuta, Yoshiko
Kako, Shinichi
author_facet Akahoshi, Yu
Nishiwaki, Satoshi
Mizuta, Shuichi
Ohashi, Kazuteru
Uchida, Naoyuki
Tanaka, Masatsugu
Fukuda, Takahiro
Ozawa, Yukiyasu
Takahashi, Satoshi
Onizuka, Makoto
Shiratori, Souichi
Nakamae, Hirohisa
Kanda, Yoshinobu
Ichinohe, Tatsuo
Atsuta, Yoshiko
Kako, Shinichi
author_sort Akahoshi, Yu
collection PubMed
description Tyrosine kinase inhibitor (TKI) administration after allogeneic hematopoietic stem cell transplantation (HSCT) may carry a survival benefit in Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph+ ALL). Therefore, we investigated whether TKI prophylaxis for negative‐minimal residual disease (MRD) after HSCT would improve patient outcomes in this nationwide retrospective cohort study. We included patients with Ph+ ALL who underwent their first allogeneic HSCT between 2001 and 2016, received TKI before HSCT, and achieved negative‐MRD status within 180 days after HSCT. Of 850 patients for inclusion, 50 patients received TKI prophylaxis, mostly imatinib or dasatinib (median dose: 400 mg with imatinib and 40 mg with dasatinib). In a multivariate analysis, disease status at HSCT was the sole risk factor for relapse (hazard ratio, 3.58; P < .001 for positive‐MRD with complete remission [CR] and hazard ratio, 6.13; P < .001 for active disease). TKI prophylaxis was not associated with a decreased risk of relapse or superior overall survival in either the whole cohort or in the analysis limited to negative‐MRD or positive‐MRD with CR1 at HSCT. Meanwhile, TKI prophylaxis limited to dasatinib might be associated with a decreased risk of relapse (hazard ratio, 0.34; P = .140), unlike imatinib. Alternative strategies using new‐generation TKI for high‐risk patients are warranted to improve the outcomes after allogeneic HSCT.
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spelling pubmed-67786392019-10-11 Tyrosine kinase inhibitor prophylaxis after transplant for Philadelphia chromosome‐positive acute lymphoblastic leukemia Akahoshi, Yu Nishiwaki, Satoshi Mizuta, Shuichi Ohashi, Kazuteru Uchida, Naoyuki Tanaka, Masatsugu Fukuda, Takahiro Ozawa, Yukiyasu Takahashi, Satoshi Onizuka, Makoto Shiratori, Souichi Nakamae, Hirohisa Kanda, Yoshinobu Ichinohe, Tatsuo Atsuta, Yoshiko Kako, Shinichi Cancer Sci Original Articles Tyrosine kinase inhibitor (TKI) administration after allogeneic hematopoietic stem cell transplantation (HSCT) may carry a survival benefit in Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph+ ALL). Therefore, we investigated whether TKI prophylaxis for negative‐minimal residual disease (MRD) after HSCT would improve patient outcomes in this nationwide retrospective cohort study. We included patients with Ph+ ALL who underwent their first allogeneic HSCT between 2001 and 2016, received TKI before HSCT, and achieved negative‐MRD status within 180 days after HSCT. Of 850 patients for inclusion, 50 patients received TKI prophylaxis, mostly imatinib or dasatinib (median dose: 400 mg with imatinib and 40 mg with dasatinib). In a multivariate analysis, disease status at HSCT was the sole risk factor for relapse (hazard ratio, 3.58; P < .001 for positive‐MRD with complete remission [CR] and hazard ratio, 6.13; P < .001 for active disease). TKI prophylaxis was not associated with a decreased risk of relapse or superior overall survival in either the whole cohort or in the analysis limited to negative‐MRD or positive‐MRD with CR1 at HSCT. Meanwhile, TKI prophylaxis limited to dasatinib might be associated with a decreased risk of relapse (hazard ratio, 0.34; P = .140), unlike imatinib. Alternative strategies using new‐generation TKI for high‐risk patients are warranted to improve the outcomes after allogeneic HSCT. John Wiley and Sons Inc. 2019-08-29 2019-10 /pmc/articles/PMC6778639/ /pubmed/31402561 http://dx.doi.org/10.1111/cas.14167 Text en © 2019 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Akahoshi, Yu
Nishiwaki, Satoshi
Mizuta, Shuichi
Ohashi, Kazuteru
Uchida, Naoyuki
Tanaka, Masatsugu
Fukuda, Takahiro
Ozawa, Yukiyasu
Takahashi, Satoshi
Onizuka, Makoto
Shiratori, Souichi
Nakamae, Hirohisa
Kanda, Yoshinobu
Ichinohe, Tatsuo
Atsuta, Yoshiko
Kako, Shinichi
Tyrosine kinase inhibitor prophylaxis after transplant for Philadelphia chromosome‐positive acute lymphoblastic leukemia
title Tyrosine kinase inhibitor prophylaxis after transplant for Philadelphia chromosome‐positive acute lymphoblastic leukemia
title_full Tyrosine kinase inhibitor prophylaxis after transplant for Philadelphia chromosome‐positive acute lymphoblastic leukemia
title_fullStr Tyrosine kinase inhibitor prophylaxis after transplant for Philadelphia chromosome‐positive acute lymphoblastic leukemia
title_full_unstemmed Tyrosine kinase inhibitor prophylaxis after transplant for Philadelphia chromosome‐positive acute lymphoblastic leukemia
title_short Tyrosine kinase inhibitor prophylaxis after transplant for Philadelphia chromosome‐positive acute lymphoblastic leukemia
title_sort tyrosine kinase inhibitor prophylaxis after transplant for philadelphia chromosome‐positive acute lymphoblastic leukemia
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778639/
https://www.ncbi.nlm.nih.gov/pubmed/31402561
http://dx.doi.org/10.1111/cas.14167
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