Comparison of long‐term outcomes between imatinib and dasatinib prophylaxis after allogeneic stem cell transplantation in patients with Philadelphia‐positive acute lymphoblastic leukemia: A multicenter retrospective study

Author:

Guan Fangshu1ORCID,Yang Luxin1,Chen Yi2,Shi Jimin1,Song Xiaolu3,Lai Xiaoyu1,Lu Ying4,Liu Lizhen1,Ouyang Guifang5,Zhao Yanmin1,Yu Jian1,Xu Yang6ORCID,Lan Jianping3,Fu Huarui1,Zhao Yi1ORCID,Qiu Xi6ORCID,Zhu Panpan1,Cai Zhen1ORCID,Huang He1ORCID,Luo Yi1

Affiliation:

1. Bone Marrow Transplantation Center the First Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang China

2. Department of Hematology the First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang China

3. Cancer Center Department of Hematology Zhejiang Provincial People’s Hospital Affiliated People’s Hospital Hangzhou Zhejiang China

4. Department of Hematology the Affiliated People’s Hospital of Ningbo University Ningbo Zhejiang China

5. Department of Hematology the First Affiliated Hospital of Ningbo University Ningbo Zhejiang China

6. Department of Hematology the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang China

Abstract

AbstractBackgroundAlthough the prognosis of Philadelphia‐positive acute lymphoblastic leukemia (Ph+ ALL) has improved with the introduction of tyrosine kinase inhibitors (TKIs) and stem cell transplantation, prevention of relapse after transplantation remains a concern. The aim of this study was to compare the impact of TKI prophylaxis with imatinib and dasatinib on long‐term outcomes after transplantation.MethodsPatients with Ph+ ALL who underwent allogeneic hematopoietic stem cell transplantation (allo‐HSCT) at first complete remission (CR1) and received TKI prophylaxis after allo‐HSCT were included in this retrospective analysis. Two cohorts were established based on the choice of TKI prophylaxis: the imatinib (Ima) and dasatinib (Das) cohorts. The survival and safety outcomes of these cohorts were compared.ResultsNinety‐one patients in the Ima cohort and 50 in the Das cohort were included. After a median follow‐up of 50.6 months, the 5‐year cumulative incidence of relapse, nonrelapse mortality rate, and overall survival in the Ima and Das cohorts were 16.1% and 12.5%, 5.2% and 9.8%, and 86.5% and 77.6%, respectively, with no statistical differences. The cumulative incidence of mild chronic graft‐versus‐host disease was higher in the Das cohort. The most common adverse event was neutropenia (64.7% vs. 69.5%). The Das cohort had a higher incidence of gastrointestinal bleeding (25.5% vs. 2.3%) and gastrointestinal reaction (48.9% vs. 31.4%) than the Ima cohort. The proportion of patients treated on schedule was significantly lower in the Das cohort than in the Ima cohort, and drug intolerance was the main reason for protocol violation.ConclusionsFor patients with Ph+ ALL undergoing allo‐HSCT in CR1, imatinib prophylaxis achieved long‐term outcomes similar to those of dasatinib.

Publisher

Wiley

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