Phase II trial of hyper CVAD and dasatinib in patients with relapsed Philadelphia chromosome positive acute lymphoblastic leukemia or blast phase chronic myeloid leukemia

Dasatinib is a second generation tyrosine kinase inhibitor, with activity in imatinib resistant Ph-positive ALL.We have treated 34 patients with relapsed Philadelphia chromosome positive acute lymphoblastic leukemia(ALL) (n519) or lymphoid blast phase of chronic myelogenous leukemia (CML-LB) (n515)...

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Bibliographic Details
Published in:American journal of hematology 2014-03, Vol.89 (3), p.282
Main Authors: Benjamini, Ohad, Dumlao, Theresa Liu, Kantarjian, Hagop, O'Brien, Susan, Garcia-Manero, Guillermo, Faderl, Stefan, Jorgensen, Jeffrey, Luthra, Rajyalakshmi, Garris, Rebecca, Thomas, Deborah, Kebriaei, Partow, Champlin, Richard, Jabbour, Elias, Burger, Jan, Cortes, Jorge, Ravandi, Farhad
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Cyclophosphamide - adverse effects
Cyclophosphamide - therapeutic use
Dasatinib
Dexamethasone - adverse effects
Dexamethasone - therapeutic use
Doxorubicin - adverse effects
Doxorubicin - therapeutic use
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - pathology
Middle Aged
Philadelphia Chromosome
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology
Pyrimidines - administration & dosage
Pyrimidines - adverse effects
Recurrence
Thiazoles - administration & dosage
Thiazoles - adverse effects
Vincristine - adverse effects
Vincristine - therapeutic use
Young Adult
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Summary:Dasatinib is a second generation tyrosine kinase inhibitor, with activity in imatinib resistant Ph-positive ALL.We have treated 34 patients with relapsed Philadelphia chromosome positive acute lymphoblastic leukemia(ALL) (n519) or lymphoid blast phase of chronic myelogenous leukemia (CML-LB) (n515) with the combination of dasatinib and the hyper CVAD regimen. Prior regimens included hyper CVAD plus imatinib(n511, 4 had transplant in first CR), other combination chemotherapy (n512), monotherapy with kinase inhibitors other than dasatinib (n59), and investigational agents (n52). Pretreatment ABL mutations were noted in 10 patients. The overall response rate was 91%, with 24 patients (71%) achieving complete response(CR), and 7(21%) CR with incomplete platelet recovery (CRp). Two patients died during induction and one had progressive disease. Twenty-six patients (84%) achieved complete cytogenetic remission after one cycle of therapy. Overall, 13 patients (42%) achieved complete molecular response, and 11 patients (35%) had major molecular response (BCR-ABL/ABL
ISSN:1096-8652