Prognostic factors influencing clinical outcome of allogeneic hematopoietic stem cell transplantation following imatinib-based therapy in BCR–ABL-positive ALL

• Published in: Blood cancer journal (New York) 2012-05, Vol.2 (5), p.e72-e72
• Main Authors: Mizuta, S, Matsuo, K, Maeda, T, Yujiri, T, Hatta, Y, Kimura, Y, Ueda, Y, Kanamori, H, Usui, N, Akiyama, H, Takada, S, Yokota, A, Takatsuka, Y, Tamaki, S, Imai, K, Moriuchi, Y, Miyazaki, Y, Ohtake, S, Ohnishi, K, Naoe, T
• Format: Article
• Language: English
• Subjects: 692/699/67/1059; 692/699/67/1990/283/2125; 692/700/1750; 692/700/565/545/576/1955; Biomedical and Life Sciences; Biomedicine; Cancer Research; Clinical outcomes; Hematology; Oncology; Original; original-article
• ISSN: 2044-5385; 2044-5385
• DOI: 10.1038/bcj.2012.18

We investigated prognostic factors for the clinical outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) following imatinib-based therapy. Among 100 adult patients who were prospectively enrolled in the JALSG Ph+ALL202 study, 97 patients obtained complete remission (CR) by imatinib-combined chemotherapy, among whom 60 underwent allo-HSCT in their first CR. The probabilities of overall survival (OS) and disease-free survival (DFS) at 3 years after HSCT were 64% (95% CI, 49–76) and 58% (95% CI, 43–70), respectively. Prognostic factor analysis revealed that the major BCR–ABL transcript was the only unfavorable predictor for OS and DFS after HSCT by both univariate (HR, 3.67 (95% CI 1.49–9.08); P =0.005 and HR, 6.25 (95% CI, 1.88–20.8); P =0.003, respectively) and multivariate analyses (HR, 3.20 (95% CI, 1.21–8.50); P =0.019 and HR, 6.92 (95% CI, 2.09–22.9); P =0.002, respectively). Minimal residual disease status at the time of HSCT had a significant influence on relapse rate ( P =0.015). Further study of the BCR–ABL subtype for the clinical impact on outcome of allo-HSCT in Ph+ALL is warranted.