# EsPhALL: imatinib after induction for children and adolescents with Philadelphia chromosome-positive acute lymphoblastic leukaemia

Source: https://onco.cc/key-papers/paper-esphall-imatinib-biondi-lancet-oncol-2012/  
OnCo record `paper-esphall-imatinib-biondi-lancet-oncol-2012` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In this European trial, adding intermittent imatinib to intensive chemotherapy for childhood Philadelphia-positive leukaemia improved disease-free survival in good-risk patients and supported its use in every child with the disease.

## Summary

European intergroup study of 178 children with Ph-positive ALL; 108 good-risk patients were randomised to imatinib or no imatinib in addition to BFM-type chemotherapy, and poor-risk patients all received imatinib; most underwent transplant.

Four-year disease-free survival was 72.9 percent with imatinib against 61.7 percent without in good-risk patients (not statistically significant by intention to treat but significant as treated), and toxicity was acceptable.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet Oncology
- Year: 2012
- DOI: 10.1016/S1470-2045(12)70377-7
- Authors: Biondi A, Schrappe M, De Lorenzo P, et al.
- Findings: Four-year disease-free survival 72.9 percent vs 61.7 percent in good-risk patients.; Poor-risk patients on imatinib: four-year disease-free survival 53.5 percent.
- What it means: Together with AALL0031, EsPhALL established kinase inhibitor plus chemotherapy as standard for paediatric Ph-positive ALL, with later trials giving imatinib continuously and reducing transplant.
- Caveats: Randomisation was stopped early after AALL0031 results; intention-to-treat difference not significant.; Intermittent imatinib schedule was later replaced by continuous dosing.

## Sources

- Lancet Oncol 2012: https://doi.org/10.1016/S1470-2045(12)70377-7
- PubMed: https://pubmed.ncbi.nlm.nih.gov/22898679/

## Connected records

- cancers: [Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL)](https://onco.cc/cancers/all-paediatric-ph-positive/)
- drugs: [Imatinib](https://onco.cc/drugs/imatinib/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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