The evolving role of chemotherapy and hematopoietic cell transplants in Ph-positive acute lymphoblastic leukemia in adults

Mark R Litzow, A. K. Fielding, S. M. Luger, E. Paietta, Y. Ofran, J. M. Rowe, A. H. Goldstone, M. S. Tallman, H. M. Lazarus

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

The introduction of the tyrosine kinase inhibitors (TKI) into the treatment of patients with Ph or BCR-ABL1-positive acute lymphoblastic leukemia has revolutionized the treatment of this poor prognosis acute leukemia. The combination of TKI with chemotherapy has improved response rates and allowed more patients to proceed to allogeneic hematopoietic cell transplant (alloHCT). Older patients have excellent responses to TKI and corticosteroids or in combination with minimal chemotherapy. This raises the question as to whether patients require full-intensity chemotherapy with TKI to achieve molecular remissions. The pediatricians have proposed that cure is achievable without alloHCT in children. These results have suggested that many patients may not require traditional chemotherapy in addition to TKI to achieve remission, and that patients who achieve a negative minimal residual disease state may not require alloHCT. The data in support of these questions is presented here and a suggested future clinical trial design based on these data is proposed.

Original languageEnglish (US)
Pages (from-to)1592-1598
Number of pages7
JournalBone Marrow Transplantation
Volume52
Issue number12
DOIs
StatePublished - Dec 1 2017

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Protein-Tyrosine Kinases
Transplants
Drug Therapy
Residual Neoplasm
Adrenal Cortex Hormones
Leukemia
Clinical Trials
Therapeutics

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

The evolving role of chemotherapy and hematopoietic cell transplants in Ph-positive acute lymphoblastic leukemia in adults. / Litzow, Mark R; Fielding, A. K.; Luger, S. M.; Paietta, E.; Ofran, Y.; Rowe, J. M.; Goldstone, A. H.; Tallman, M. S.; Lazarus, H. M.

In: Bone Marrow Transplantation, Vol. 52, No. 12, 01.12.2017, p. 1592-1598.

Research output: Contribution to journalReview article

Litzow, MR, Fielding, AK, Luger, SM, Paietta, E, Ofran, Y, Rowe, JM, Goldstone, AH, Tallman, MS & Lazarus, HM 2017, 'The evolving role of chemotherapy and hematopoietic cell transplants in Ph-positive acute lymphoblastic leukemia in adults', Bone Marrow Transplantation, vol. 52, no. 12, pp. 1592-1598. https://doi.org/10.1038/bmt.2017.110
Litzow, Mark R ; Fielding, A. K. ; Luger, S. M. ; Paietta, E. ; Ofran, Y. ; Rowe, J. M. ; Goldstone, A. H. ; Tallman, M. S. ; Lazarus, H. M. / The evolving role of chemotherapy and hematopoietic cell transplants in Ph-positive acute lymphoblastic leukemia in adults. In: Bone Marrow Transplantation. 2017 ; Vol. 52, No. 12. pp. 1592-1598.
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