Treatment of Philadelphia chromosome-positive acute lymphocytic leukemia with hyper-CVAD and imatinib mesylate

Deborah A. Thomas, Stefan Faderl, Jorge Cortes, Susan O'Brien, Francis J. Giles, Steven M. Kornblau, Guillermo Garcia-Manero, Michael J. Keating, Michael Andreeff, Sima Jeha, Miloslav Beran, Srdan Verstovsek, Sherry Pierce, Laurie Letvak, August Salvado, Richard Champlin, Moshe Talpaz, Hagop Kantarjian

Research output: Contribution to journalArticle

Abstract

Imatinib mesylate, an inhibitor of the Bcr-Abl tyrosine kinase, has modest activity in refractory/relapsed Philadelphia chromosome (Ph)-positive acute lymphocytic leukemia (ALL). Use of concurrent chemotherapy and imatinib mesylate in newly diagnosed Ph-positive ALL was explored. There were 20 patients who received hyper-CVAD (cyclophosphamide, vincristine, Adriamycin, and dexamethasone) and imatinib mesylate followed by imatinib mesylate-based consolidation/maintenance therapy. Of these patients, 11 had de novo disease, 4 were primary failures after induction (without imatinib mesylate), and 5 were in complete remission (CR) after induction (without imatinib mesylate). All 15 patients treated for active disease achieved CR. Within a median of 3.5 months in first CR, 10 patients underwent allogeneic stem cell transplantation (SCT). One patient relapsed after matched related SCT. The other 9 patients remained alive in CR with median follow-up of 12 months after SCT (range, 1+ to 17+ months). Among 10 patients ineligible for (no donor or older age) or refusing allogeneic SCT, 1 patient relapsed after one year. There were 5 patients who remained alive in continuous CR for a median of 20 months (range, 4+ to 24+ months), with 2 older patients dying in CR at 15 and 16 months of comorbid conditions. Molecular CRs were achieved in both groups (SCT or no SCT). Outcome with hyper-CVAD and imatinib mesylate appears better than with prior regimens; continued accrual and longer follow-up of the current cohort is needed.

Original languageEnglish (US)
Pages (from-to)4396-4407
Number of pages12
JournalBlood
Volume103
Issue number12
DOIs
StatePublished - Jun 15 2004
Externally publishedYes

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Philadelphia Chromosome
Chromosomes
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Stem cells
Stem Cell Transplantation
Therapeutics
bcr-abl Fusion Proteins
Chemotherapy
Vincristine
Imatinib Mesylate
Consolidation
Refractory materials
Doxorubicin
Cyclophosphamide
Dexamethasone
Remission Induction
Tissue Donors
Drug Therapy

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Thomas, D. A., Faderl, S., Cortes, J., O'Brien, S., Giles, F. J., Kornblau, S. M., ... Kantarjian, H. (2004). Treatment of Philadelphia chromosome-positive acute lymphocytic leukemia with hyper-CVAD and imatinib mesylate. Blood, 103(12), 4396-4407. https://doi.org/10.1182/blood-2003-08-2958

Treatment of Philadelphia chromosome-positive acute lymphocytic leukemia with hyper-CVAD and imatinib mesylate. / Thomas, Deborah A.; Faderl, Stefan; Cortes, Jorge; O'Brien, Susan; Giles, Francis J.; Kornblau, Steven M.; Garcia-Manero, Guillermo; Keating, Michael J.; Andreeff, Michael; Jeha, Sima; Beran, Miloslav; Verstovsek, Srdan; Pierce, Sherry; Letvak, Laurie; Salvado, August; Champlin, Richard; Talpaz, Moshe; Kantarjian, Hagop.

In: Blood, Vol. 103, No. 12, 15.06.2004, p. 4396-4407.

Research output: Contribution to journalArticle

Thomas, DA, Faderl, S, Cortes, J, O'Brien, S, Giles, FJ, Kornblau, SM, Garcia-Manero, G, Keating, MJ, Andreeff, M, Jeha, S, Beran, M, Verstovsek, S, Pierce, S, Letvak, L, Salvado, A, Champlin, R, Talpaz, M & Kantarjian, H 2004, 'Treatment of Philadelphia chromosome-positive acute lymphocytic leukemia with hyper-CVAD and imatinib mesylate', Blood, vol. 103, no. 12, pp. 4396-4407. https://doi.org/10.1182/blood-2003-08-2958
Thomas, Deborah A. ; Faderl, Stefan ; Cortes, Jorge ; O'Brien, Susan ; Giles, Francis J. ; Kornblau, Steven M. ; Garcia-Manero, Guillermo ; Keating, Michael J. ; Andreeff, Michael ; Jeha, Sima ; Beran, Miloslav ; Verstovsek, Srdan ; Pierce, Sherry ; Letvak, Laurie ; Salvado, August ; Champlin, Richard ; Talpaz, Moshe ; Kantarjian, Hagop. / Treatment of Philadelphia chromosome-positive acute lymphocytic leukemia with hyper-CVAD and imatinib mesylate. In: Blood. 2004 ; Vol. 103, No. 12. pp. 4396-4407.
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