Pretransplant administration of imatinib for allo-HSCT in patients with BCR-ABL-positive acute lymphoblastic leukemia
Shuichi Mizuta, Keitaro Matsuo, Satoshi Nishiwaki, Kiyotoshi Imai, Heiwa Kanamori, Kazuteru Ohashi, Takahiro Fukuda, Yasushi Onishi, Koichi Miyamura, Satoshi Takahashi, Makoto Onizuka, Yoshiko Atsuta, Ritsuro Suzuki, Yasuo Morishima, Koji Kato, Hisashi Sakamaki, Junji Tanaka, Shuichi Mizuta, Keitaro Matsuo, Satoshi Nishiwaki, Kiyotoshi Imai, Heiwa Kanamori, Kazuteru Ohashi, Takahiro Fukuda, Yasushi Onishi, Koichi Miyamura, Satoshi Takahashi, Makoto Onizuka, Yoshiko Atsuta, Ritsuro Suzuki, Yasuo Morishima, Koji Kato, Hisashi Sakamaki, Junji Tanaka
Abstract
We aimed to evaluate the impact of pretransplant imatinib administration on the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in adults with Philadelphia chromosome-positive (Ph(+)) acute lymphoblastic leukemia (ALL). We retrospectively analyzed 738 patients with Ph(+) ALL that underwent allo-HSCT between 1990 and 2010 using data from the Transplant Registry Unified Management Program of the Japan Society of Hematopoietic Cell Transplantation. We compared the allo-HSCT outcomes between 542 patients who received imatinib before allo-HSCT during the initial complete remission period (imatinib cohort) and 196 patients who did not receive imatinib (non-imatinib cohort). The 5-year overall survival after allo-HSCT was significantly higher in the imatinib cohort than in the non-imatinib cohort (59% vs 38%; 95% confidence interval [CI], 31-45%; P < .001). Multivariate analysis indicated that pretransplant imatinib administration had beneficial effects on overall survival (hazard ratio [HR], 0.57; 95% CI, 0.42-0.77; P < .001), relapse (HR, 0.66; 95% CI, 0.43-0.99; P = .048), and nonrelapse mortality (HR, 0.55; 95% CI, 0.37-0.83; P = .005). In conclusion, our study showed that imatinib administration before allo-HSCT had advantageous effects on the clinical outcomes of allo-HSCT in patients with Ph(+) ALL.
Source: PubMed