{"entity":{"id":"paper-esphall2010-continuous-imatinib-biondi-lancet-haematol-2018","kind":"paper","name":"EsPhALL2010: continuous imatinib with chemotherapy in paediatric Philadelphia chromosome-positive ALL","aka":[],"tldr":"Giving children with Philadelphia-positive leukaemia the pill imatinib continuously from the second week of treatment allowed fewer of them to need a transplant, with survival similar to the earlier study that used short courses, but at the cost of more serious toxicity during intensive treatment blocks.","summary":"Prospective, intergroup, open-label, single-arm trial across 11 study groups in Europe, Chile and Hong Kong: 155 patients aged 1 to 17 with Philadelphia chromosome-positive acute lymphoblastic leukaemia received imatinib 300 mg/m2 from day 15 of induction continuously through chemotherapy, with transplant reserved for poor early responders (38 percent were transplanted in first remission).\n\nFive-year event-free survival was 57.0 percent and overall survival 71.8 percent, similar to EsPhALL2004 despite fewer transplants. 154 serious adverse events occurred in 80 patients, mostly infections during high-risk blocks and delayed intensifications, including 14 fatal events.","asOf":"2026-09-22","links":[{"label":"Lancet Haematol 2018","url":"https://doi.org/10.1016/S2352-3026(18)30173-X"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/30501871/"}],"tags":[],"related":[],"cancers":["all-paediatric-ph-positive","all-leukemia"],"sections":[],"technologies":[],"targets":[],"drugs":["imatinib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["esphall"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-haematology"],"dependsOn":[],"notes":[],"journal":"The Lancet Haematology","year":2018,"doi":"10.1016/S2352-3026(18)30173-X","pmid":"30501871","authors":"Biondi A, Gandemer V, De Lorenzo P, et al.","paperType":"observational","findings":["Five-year event-free survival 57.0 percent (95% CI 48.5 to 64.6) and overall survival 71.8 percent (63.5 to 78.5).","38 percent of patients had transplant in first remission, fewer than in EsPhALL2004, with similar survival.","Serious adverse events in 52 percent of patients, 14 fatal, concentrated in high-risk blocks and delayed intensification."],"whatItMeans":"Continuous imatinib from induction lets many children with Philadelphia-positive ALL avoid transplant, but the intensive BFM backbone is toxic; later trials reduced chemotherapy intensity under tyrosine kinase inhibitor cover.","caveats":["Single-arm design compared with the earlier EsPhALL2004 cohort rather than a concurrent control."],"changedPractice":true,"participants":155},"route":"/key-papers/paper-esphall2010-continuous-imatinib-biondi-lancet-haematol-2018/","neighbours":{"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"},{"id":"all-paediatric-ph-positive","kind":"cancer","name":"Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL)","route":"/cancers/all-paediatric-ph-positive/"}],"drug":[{"id":"imatinib","kind":"drug","name":"Imatinib","route":"/drugs/imatinib/"}],"trial":[{"id":"esphall","kind":"trial","name":"EsPhALL (EsPhALL2004 and EsPhALL2010)","route":"/trials/esphall/"}],"journal":[{"id":"lancet-haematology","kind":"journal","name":"The Lancet Haematology","route":"/journals/lancet-haematology/"}]}}