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The treatment of pediatric Philadelphia positive (Ph+) leukemias in the imatinib era. Pediatr Blood Cancer 2009 Dec;53(6):992-5

Date

07/22/2009

Pubmed ID

19621426

DOI

10.1002/pbc.22172

Scopus ID

2-s2.0-71049160882   8 Citations

Abstract

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 R

Author

Michael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Benzamides
Canada
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
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a