The treatment of pediatric Philadelphia positive (Ph+) leukemias in the imatinib era.

Full Abstract

BACKGROUND: As the treatment of Philadelphia positive (Ph+) leukemias in the era of imatinib continues to evolve, the role of allogeneic hematopoietic cell transplantation (allogeneic-HCT) in first remission is becoming more unclear. PROCEDURE: Thirty-two pediatric centers across the United States and Canada were surveyed regarding current treatment practices for Ph+ acute lymphoblastic leukemia (ALL) and chronic myelogenous leukemia (CML). The survey addressed treatment approaches for Ph+ ALL and CML in terms of imatinib therapy and use of allogeneic-HCT. RESULTS: Twenty-three of the 32 centers returned the survey to provide a 72% response rate. Of the 27 physicians responding to the survey, 22 (81%) recommended a matched sibling donor (MSD) allogeneic-HCT, when available, in first remission for Ph+ ALL compared to 17/27 (63%) for patients with first chronic phase CML. There was universal agreement among survey responders regarding the use of imatinib upfront in Ph+ ALL and CML patients while 13 of 27 (48%) physicians reported using imatinib as maintenance therapy post-HCT for Ph+ ALL compared to 9 of 27 (33%) for CML. CONCLUSIONS: Although a treatment consensus did not exist based on the results of this small survey, current treatment practices for pediatric Ph+ ALL and CML appear to favor allogeneic-HCT when a MSD is available. The use of post-HCT imatinib as maintenance therapy to avoid relapse for either Ph+ ALL or CML remains uncertain and awaits future prospective studies.

Author information

Author/s: Burke, Michael J (MJ); Willert, Jennifer (J); Desai, Sunil (S); Kadota, Richard (R);

Affiliation: Division of Pediatric Hematology/Oncology/Blood and Marrow Transplantation, University of Minnesota Children's Hospital-Fairview, Minneapolis, Minnesota 55455, USA. burke283(-atsign-)umn.edu

Journal and publication information

Publication Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't

Journal: Pediatric blood & cancer (Pediatr Blood Cancer), published in United States. (Language: eng)

Reference: 2009-Dec; vol 53 (issue 6) : pp 992-5

Dates: Created 2009/09/16; Completed 2009/10/13;

PMID: 19621426, status: MEDLINE (last retrieved date: 10/13/2009)

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