EsPhALL2010: continuous imatinib with chemotherapy in paediatric Philadelphia chromosome-positive ALL
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.
Overview
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).
Five-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.
- 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.
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.
- Single-arm design compared with the earlier EsPhALL2004 cohort rather than a concurrent control.
Similar pages
not linked directly; found by shared links- Key paperEsPhALL: imatinib after induction for children and adolescents with Philadelphia chromosome-positive acute lymphoblastic leukaemia
Shares EsPhALL (EsPhALL2004 and EsPhALL2010), Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib.
- Key paperAALL0031: imatinib with intensive chemotherapy for Philadelphia chromosome-positive acute lymphoblastic leukaemia in children
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib.
- Key paperDasatinib versus imatinib with chemotherapy for paediatric Philadelphia chromosome-positive acute lymphoblastic leukaemia (CCCG-ALL-2015)
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib.
- TrialPhALLCON
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib, Acute lymphoblastic leukaemia.
- TermPh-positive ALL
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib, Acute lymphoblastic leukaemia.
- PersonStephen P. Hunger
Shares Imatinib, Acute lymphoblastic leukaemia.
- PairingBCR::ABL1 TKI + blinatumomab (chemotherapy-free Ph+ ALL)
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Acute lymphoblastic leukaemia.
- Key paperTalicabtagene autoleucel for relapsed or refractory B-cell malignancies: an open-label, multicentre, phase 1/2 study
Shares The Lancet Haematology, Acute lymphoblastic leukaemia.