The treatment of pediatric Philadelphia positive (Ph+) leukemias in the imatinib era. Pediatr Blood Cancer 2009 Dec;53(6):992-5
Date
07/22/2009Pubmed ID
19621426DOI
10.1002/pbc.22172Scopus ID
2-s2.0-71049160882 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
BACKGROUND: As the treatment of Philadelphia positive (Ph+) leukemias in the era of imatinib continues to evolve, the role of allogeneic hematopoietic cell transplantation (allogeneic-HCT) in first remission is becoming more unclear.
PROCEDURE: Thirty-two pediatric centers across the United States and Canada were surveyed regarding current treatment practices for Ph+ acute lymphoblastic leukemia (ALL) and chronic myelogenous leukemia (CML). The survey addressed treatment approaches for Ph+ ALL and CML in terms of imatinib therapy and use of allogeneic-HCT.
RESULTS: Twenty-three of the 32 centers returned the survey to provide a 72% response rate. Of the 27 physicians responding to the survey, 22 (81%) recommended a matched sibling donor (MSD) allogeneic-HCT, when available, in first remission for Ph+ ALL compared to 17/27 (63%) for patients with first chronic phase CML. There was universal agreement among survey responders regarding the use of imatinib upfront in Ph+ ALL and CML patients while 13 of 27 (48%) physicians reported using imatinib as maintenance therapy post-HCT for Ph+ ALL compared to 9 of 27 (33%) for CML.
CONCLUSIONS: Although a treatment consensus did not exist based on the results of this small survey, current treatment practices for pediatric Ph+ ALL and CML appear to favor allogeneic-HCT when a MSD is available. The use of post-HCT imatinib as maintenance therapy to avoid relapse for either Ph+ ALL or CML remains uncertain and awaits future prospective studies.
Author List
Burke MJ, Willert J, Desai S, Kadota RAuthor
Michael James Burke MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
BenzamidesCanada
Data Collection
Hematopoietic Stem Cell Transplantation
Humans
Imatinib Mesylate
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Physicians
Piperazines
Practice Patterns, Physicians'
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Pyrimidines
Siblings
Tissue Donors
Transplantation, Homologous
United States