Response to ponatinib before hematopoietic stem cell transplantation in a child with relapsed Philadelphia chromosome-positive acute lymphoblastic leukemia

2018 ◽  
Vol 60 (1) ◽  
pp. 85-87 ◽  
Author(s):  
Masaki Yamamoto ◽  
Tsukasa Hori ◽  
Keita Igarashi ◽  
Hiroyuki Shimada ◽  
Hiroyuki Tsutsumi
Keyword(s):  
Stem Cell ◽  
Acute Lymphoblastic Leukemia ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
Hematopoietic Stem ◽  
Philadelphia Chromosome Positive

Minimal Risidual Disease monitoring in Childhood Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia: Preliminary Results of JPLSG Ph+ALL04.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4116-4116
Author(s):  
Hirohide Kawasaki ◽  
Souichi Adachi ◽  
Akira Ohara ◽  
Atsushi Kikuta ◽  
Atsushi Sato ◽  
...  
Keyword(s):  
Stem Cell ◽  
Acute Lymphoblastic Leukemia ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
Induction Phase ◽  
Hematopoietic Stem

Abstract Abstract 4116 Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ALL) is very rare and poor prognostic condition in children. Japanese Pediatric Leukemia/Lymphoma Study Group (JPLSG) conducted first nationwide clinical trial for Ph+ALL in children (Ph+ALL04). Ph+ALL04 consists of five therapy phases; Induction phase (five drugs induction), Intensification phase (high-dose CA and BFM Ib), Re-induction phase (four drugs re-induction), Imatinib mono-therapy phase, and hematopoietic stem cell transplantation phase (VP+CY+TBI condioning). Before and after each phase, BCR-ABL minimal residual disease (MRD) was monitored by the real-time PCR method. During the period 2004-08, 44 patients were enrolled in the Ph+ALL04 study. Out of 44 patients, five were resistant to Induction Phase and did not achieve CR. Their levels of BCR-ABL transcript at diagnosis were significantly higher than that of patients achieved CR after Induction phase. After Induction phase, 39 patients achieved CR, and seven of 39 patients also achieved MRD negative. After Intensification phase, two patients relapsed. Thirty-four patients were still in CR, and 10 patients also achieved MRD negative after Intensification phase. One patient relapsed after Re-induction phase and three patients relapsed after Imatinib mono-therapy phase. Thirteen patients were MRD negative before Imatinib mono-therapy phase, and 14 patients were MRD negative after Imatinib mono-therapy phase. Before Hematopoietic stem cell transplantation phase, 14 patients were MRD negative. Twenty-six patients received hematopoietic stem cell transplantation. Out of 26 patients, three relapsed after hematopoietic cell transplantation. Twenty-three patients continued to be in CR and MRD negative for median 2 years after hematopoietic stem cell transplantation. In conclusion, amount of BCR-ABL transcript is a possible predictor for achieving remission after induction therapy in Ph+ALL children. MRD detection during therapy is confirmed the important prognostic indicator in the context of the intensive chemotherapy and hematopoietic stem cell transplantation in Ph+ALL children. Disclosures: No relevant conflicts of interest to declare.

Dasatinib Restores Full Donor Chimerism in Animatinib - Resistant Ph+ ALL Childwith E255K Gene Mutation Relapse Dafter Allo HSCT

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4827-4827
Author(s):  
Ching-Tien Peng ◽  
Gevorg Tamamyan ◽  
Kang-Hsi WU
Keyword(s):  
Stem Cell ◽  
Acute Lymphoblastic Leukemia ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Gene Mutation ◽  
Hematopoietic Stem Cell ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
Hematopoietic Stem ◽  
Philadelphia Chromosome Positive

Abstract Abstract 4827 Philadelphia chromosome positive acute lymphoblastic leukemia is uncommon among children and very tough to treat. With chemotherapy alone, only 20–30% of children are cured, but tyrosine kinase inhibitors (TKIs) plus chemotherapy and allogeneic hematopoietic stem cell transplantation in 1st complete remission has gradually high possibility of cure. Some recent papers also suggest that chemotherapy plus tyrosine kinase inhibitors (TKIs) may be the initial treatment of choice. Despite this, there is a few data about treatment after relapse. We introduce a case of 15 years old boy with Philadelphia chromosome positive acute lymphoblastic leukemia early relapse after full-match related donor hematopoietic stem cell transplantation from his mother. Both at the time of diagnosis and at relapse time the patient had various cytogenetic abnormalities and also at relapse he revealed with imatinib-resistant E255K gene mutation, which is a common mutation that occurs frequently after imatinib therapy in Ph-positive ALL patients is the glutamic acid to lysine mutation at codon 255. After the relapse the boy received high-dose chemotherapy and dasatinib and obtained complete molecular remission and restored full donor chimerism. There were no observed side effects of dasatinib treatment. The patient is now still in complete molecular remission and is continuing maintenance chemotherapy with dasatinib. Thus, this case suggests that chemotherapy plus dasatinibcould be a treatment of choice for the children with relapsed Philadelphia chromosome positive acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation, which alsohas E255K gene mutation and various cytogenetic abnormalities. Disclosures: No relevant conflicts of interest to declare.

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