Frontline combination of dasatinib and low-intensity chemotherapy in adults with de novo Philadelphia chromosome-positive acute lymphoblastic leukemia.
Expert Rev Hematol
; 17(4-5): 173-180, 2024.
Article
en En
| MEDLINE
| ID: mdl-38616308
ABSTRACT
BACKGROUND:
Studies on dasatinib-based low-intensity induction regimens and post-remission strategies are limited in China. Therefore, we conducted a single-center phase 2 trial in newly diagnosed adult patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) to establish the efficacy and safety of this treatment approach. RESEARCH DESIGN ANDMETHODS:
Patients received one month of dasatinib plus low-intensity chemotherapy and two months of dasatinib monotherapy for induction, followed by a single course of high-dose methotrexate for consolidation. Subsequently, they underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) or tyrosine kinase inhibitor (TKI)-based treatment for maintenance therapy between October 2015 and August 2022.RESULTS:
Twenty-two patients were enrolled. Median age was 45 years (range, 20-71). The rates of major and complete molecular responses in the third month were 18.2% and 40.9% respectively. With a median follow-up of 15 months (range, 5-89), the estimated 3-year disease-free survival (DFS) and overall survival (OS) were 52.4% and 73.2%, respectively. The TKI-based cohort had a significantly poorer DFS (p = 0.014) and OS (p = 0.008) than the allo-HSCT cohort.CONCLUSIONS:
Our results suggest that dasatinib-based low-intensity chemotherapy is safe and effective as an induction strategy in the Chinese population. Allo-HSCT plays a crucial role in the long-term outcomes of patients with Ph+ ALL. CLINICAL TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov as NCT02690922.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Cromosoma Filadelfia
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Protocolos de Quimioterapia Combinada Antineoplásica
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Trasplante de Células Madre Hematopoyéticas
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Leucemia-Linfoma Linfoblástico de Células Precursoras
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Dasatinib
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Expert Rev Hematol
Asunto de la revista:
HEMATOLOGIA
Año:
2024
Tipo del documento:
Article