AALL0031: imatinib with intensive chemotherapy for Philadelphia chromosome-positive acute lymphoblastic leukaemia in children
Adding continuous imatinib to intensive chemotherapy more than doubled three-year event-free survival in childhood Philadelphia-positive leukaemia compared with historical controls and matched the results of transplant, changing the standard of care.
Overview
Children's Oncology Group study of 92 children with Ph-positive ALL treated with intensive chemotherapy plus imatinib for increasing durations across cohorts, with transplant for those with a sibling donor.
Three-year event-free survival in the cohort with continuous imatinib was 80 percent, more than double the 35 percent of historical controls, and no worse than with sibling donor transplant; toxicity was not increased.
- Three-year event-free survival 80 percent with continuous imatinib vs 35 percent in historical controls.
- Chemotherapy plus imatinib comparable to sibling donor transplant.
A tyrosine kinase inhibitor throughout chemotherapy is the standard for childhood Ph-positive ALL, and transplant in first remission is no longer routine.
- Non-randomised comparison with historical controls; small cohorts.
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