Wassmann, Barbara and Pfeifer, Heike and Goekbuget, Nicola and Beelen, Dietrich W. and Beck, Joachim and Stelljes, Matthias and Bornhaeuser, Martin and Reichle, Albrecht and Perz, Jolanta and Haas, Rainer and Ganser, Arnold and Schmid, Mathias and Kanz, Lothar and Lenz, Georg and Kaufmann, Martin and Binckebanck, Anja and Brueck, Patrick and Reutzel, Regina and Gschaidmeier, Harald and Schwartz, Stefan and Hoelzer, Dieter and Ottmann, Oliver G. (2006) Alternating versus concurrent schedules of imatinib and chemotherapy as front-line therapy for Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL). BLOOD, 108 (5). pp. 1469-1477. ISSN 0006-4971, 1528-0020
Full text not available from this repository. (Request a copy)Abstract
The best strategy for incorporating imatinib in front-line treatment of Ph+ acute lymphoblastic leukemia (ALL) has not been established. We enrolled 92 patients with newly diagnosed Ph(+)ALL in a prospective, multicenter study to investigate sequentially 2 treatment schedules with imatinib administered concurrent to or alternating with a uniform induction and consolidation regimen. Coadministration of imatinib and induction cycle 2 (INDII) resulted in a complete remission (CR) rate of 95%a and polymerase chain reaction (PCR) negativity for BCR-ABL in 52% of patients, compared with 19% in patients in the alternating treatment cohort (P = .01). Remarkably, patients with and without a CR after induction cycle 1 (INDI) had similar hematologic and molecular responses after concurrent imatinib and INDII. In the concurrent cohort, grades III and IV cytopenias and transient hepatotoxicity necessitated interruption of induction in 87% and 53% of patients, respectively; however, duration of induction was not prolonged when compared with patients receiving chemotherapy alone. No imatinib-related severe hematologic or nonhematologic toxicities were noted with the alternating schedule. In each cohort, 77% of patients underwent allogeneic stem cell transplantation (SCT) in first CR (CR1). Both schedules of imatinib have acceptable toxicity and facilitate SCT in CR1 in the majority of patients, but concurrent administration of imatinib and chemotherapy has greater antileukemic efficacy.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACUTE LYMPHOCYTIC-LEUKEMIA; TYROSINE KINASE INHIBITOR; BONE-MARROW-TRANSPLANTATION; STEM-CELL TRANSPLANTATION; COLONY-STIMULATING FACTOR; RESIDUAL DISEASE PRIOR; RANDOMIZED PHASE-III; INDUCTION CHEMOTHERAPY; ANTILEUKEMIC AGENTS; COMPLETE REMISSION; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Feb 2021 10:34 |
| Last Modified: | 01 Feb 2021 10:34 |
| URI: | https://pred.uni-regensburg.de/id/eprint/34054 |
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