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Successful treatment of two cases with Philadelphia-chromosome positive acute lymphoblastic leukemia who relapsed after allogeneic stem cell transplantation and the treatments with novel immunotherapies and ponatinib.
Tachibana, Takayoshi; Tanaka, Masatsugu; Noguchi, Yuma; Najima, Yuho; Sadato, Daichi; Harada, Yuka; Tamai, Yotaro; Doki, Noriko; Nakajima, Hideaki.
Afiliação
  • Tachibana T; Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
  • Tanaka M; Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
  • Noguchi Y; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
  • Najima Y; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
  • Sadato D; Clinical Research Support Center, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
  • Harada Y; Clinical Research Support Center, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
  • Tamai Y; Division of Hematology, Shonan Kamakura General Hospital, Kamakura, Japan.
  • Doki N; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
  • Nakajima H; Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan.
Hematology ; 29(1): 2360843, 2024 Dec.
Article em En | MEDLINE | ID: mdl-38828928
ABSTRACT
The outcomes of relapsed Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) resistant to new drugs such as tyrosine kinase inhibitors, inotuzumab ozogamicin (InO) and blinatumomab are dismal. We treated two cases of Ph+ALL resistant to these drugs that achieved long-term survival after treatment with chimeric antigen receptor (CAR)-T cell therapy or a second allogeneic hematopoietic stem cell transplantation (HCT) with a sequential conditioning regimen. Case 1 A 15-year-old boy was diagnosed with Ph+ALL. Despite the second HCT after the treatment of ponatinib and blinatumomab, hematological relapse occurred. InO was ineffective and he was transferred to a CAR-T center. After the CAR-T cell therapy, negative measurable residual disease (MRD) was achieved and maintained for 38 months without maintenance therapy. Case 2 A 21-year-old man was diagnosed with Ph+ALL. Hematological relapse occurred after the first HCT. Despite of the treatment with InO, ponatinib, and blinatumomab, hematological remission was not achieved. The second HCT was performed using a sequential conditioning regimen with clofarabine. Negative MRD was subsequently achieved and maintained for 42 months without maintenance therapy. These strategies are suggestive and helpful to treat Ph+ALL resistant to multiple immunotherapies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Piridazinas / Cromossomo Filadélfia / Transplante de Células-Tronco Hematopoéticas / Leucemia-Linfoma Linfoblástico de Células Precursoras / Imidazóis Limite: Adolescent / Adult / Humans / Male Idioma: En Revista: Hematology Assunto da revista: HEMATOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Japão País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Piridazinas / Cromossomo Filadélfia / Transplante de Células-Tronco Hematopoéticas / Leucemia-Linfoma Linfoblástico de Células Precursoras / Imidazóis Limite: Adolescent / Adult / Humans / Male Idioma: En Revista: Hematology Assunto da revista: HEMATOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Japão País de publicação: Reino Unido