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Outcome of Philadelphia Positive Acute Lymphoblastic Leukemia With or Without Allogeneic Stem Cell Transplantation in a Retrospective Study

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Philadelphia positive ALL (Ph + ALL) is an aggressive leukemia associated with lower remission rates and poor survival. Current treatment approach for Ph + ALL is chemotherapy along with TKI and CNS directed therapy followed by Allogeneic stem cell transplantation (Allo-SCT). To analyze outcome of Ph + ALL with or without Allo-SCT in the era of universal TKI uses. Retrospectively reviewed medical records of 267 patients who were diagnosed and treated for ALL during study period at our centre. Fifty-one Ph + ALL patients (males = 31, females = 20) out of a total of 267 ALL patients were eligible for the study. Post induction 48 patients achieved complete remission while 1 died during induction. Forty-six patients received further treatment with TKI + CNS directed therapy and thereafter the consolidation therapy with Allo-SCT (n = 16) or chemotherapy + TKI (n = 30).Overall mortality was 7/51 (13.9%) (6/16 transplant related mortalities due to GVHD and infections and 1 induction death). Fifteen out of 46 patients (32.6%) had relapse (1/10 relapse after Allo-SCT vs. 14/24 after chemotherapy) on or after consolidation therapy. At a median follow-up of 17.5 months (2–58 months) of cohort, the median EFS was 22 months (95% CI 10.4–33.5 months). The estimated 4 year EFS and PFS in Allo-SCT versus chemotherapy only group was 36.0 ± 17.9 versus 27.3 ± 9.1% (p = 0.21) and 75 ± 21.7 versus 34.1 ± 10.9% (p = 0.02) respectively. Allo-SCT groups has a better progression free survival than chemotherapy group only. Preventing treatment related mortality can further improve outcome after Allo-SCT Ph + ALL.

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Authors and Affiliations

  1. Department of Hemato-Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Sector-5, Rohini, New Delhi, 110085, India

    Narendra Agrawal, Priyanka Verma, Neha Yadav, Rayaz Ahmed, Pallavi Mehta, Priyanka Soni, Shinto Francis & Dinesh Bhurani

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  1. Narendra Agrawal
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  2. Priyanka Verma
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  3. Neha Yadav
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Correspondence to Narendra Agrawal.

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Conflict of interest

Narendra Agrawal, Priyanka Verma, Neha Yadav, Rayaz Ahmed, Pallavi Mehta, Priyanka Soni, Shinto Francis, Dinesh Bhurani declare that they have no conflict of interest.

Ethical Approval

The study was approved by our Institutional Review Board.

Human and Animal Rights Statement

All procedures performed in study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

This is a retrospective study hence for this type of study formal consent is not required.

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Agrawal, N., Verma, P., Yadav, N. et al. Outcome of Philadelphia Positive Acute Lymphoblastic Leukemia With or Without Allogeneic Stem Cell Transplantation in a Retrospective Study. Indian J Hematol Blood Transfus 35, 240–247 (2019). https://doi.org/10.1007/s12288-018-1005-2

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  • DOI: https://doi.org/10.1007/s12288-018-1005-2

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