Ponatinib as a Prophylactic or Pre-Emptive Strategy to Prevent Cytological Relapse after Allogeneic Stem Cell Transplantation in Patients with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia Transplanted in Complete Cytological Remission †
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Ponatinib Treatment and Toxicity
3.3. Survival Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Age, Median Years (Range) | 49 | (20–70) |
---|---|---|
BCR-ABL1 transcript type | No. | % |
| 29/48 | 60% |
| 16/48 | 33% |
| 3/48 | 7% |
Leukemia status at Allo-SCT | ||
| 48/48 | 100% |
| 26/48 | 54% |
| 22/48 | 46% |
Conditioning regimen | ||
| 40/48 | 83% |
| 8/48 | 17% |
Donor type | ||
| 24/48 | 50% |
| 11/48 | 23% |
| 9/48 | 19% |
| 4/48 | 8% |
PONA maintenance post-Allo-SCT | ||
| 26/48 | 54% |
| 22/48 | 46% |
2A-PONA Therapy | Total Cases | Prophylactic Therapy (26) | Pre-Emptive Therapy (22) | p-Value |
---|---|---|---|---|
Cytologic Remission at Allo-SCT | 48/48 (100%) | 26/26 (100%) | 22/22 (100%) | |
MRD positive at Allo-SCT | 26/48 (54%) | 12/26 (46%) | 14/22 (64%) | |
MRD negative at Allo-SCT | 22/48 (46%) | 14/26 (54%) | 8/22 (36%) | |
Time from Allo-SCT to PONA start, months median (range) | 4.8 (1.5–63) | 4.3 (1.5–6) | 7.4 (2–63) | 0.01 |
Duration of PONA therapy, months’ median (range) | 22 (2–100) | 15 (2–100) | 29 (6–80) | |
2B-PONA DOSE | p-Value | |||
Starting dose (mg/day) median (range) | 30 (15–45) | 15 (15–45) | 30(15–45) | 0.038 |
| 29/48 (60%) | 21/26 (86%) | 8/22 (36%) | 0.002 |
| 10/48 (21%) | 4/26 (15%) | 6/22 (28%) | ns |
| 9/48 (19%) | 1/26 (4%) | 8/22 (36%) | 0.007 |
PONA + DLI | 10/48 (21%) | 0/26 | 10/22 (45%) | 0.00009 |
2C-PONA DOSE MODULATION | p-Value | |||
| 7/48 (15%) | 2/26 (8%) | 5/22 (23%) | ns |
| 10/48 (21%) | 2/26 (8%) | 8/22 (36%) | 0.02 |
| 5/48 (10.5%) | 4/26 (16%) | 1/22 (5%) | ns |
| ||||
All causes | 16/48 (33%) | 5/26 (19%) | 11/22 (50%) | 0.03 |
Only AE | 5/48 (10.5%) | 3/26 (12%) a | 2/22 (10%) b | ns |
All | Prophylaxis (26 pts) | Pre-Emptive (22 pts) | |
---|---|---|---|
| 4/48 (8%) | / | 4/22 (20%) |
| 3/48 (6%) | 2/26 (8%) | 1/22 (5%) |
| 3/48 (6%) | 1/26 (4%) | 2/22 (10%) |
| 1/48 (2%) | 1/26 (4%) | / |
| 2/48 (4%) | 1/26 (4%) | 1/22 (5%) |
| 1/48 (2%) | 1/26 (4%) | / |
| 1/48 (2%) | / | 1/22 (5%) |
| 5/48 (10%) | 1/26 (4%) a | 4/22 (20%) b |
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Candoni, A.; Chiusolo, P.; Lazzarotto, D.; Sartor, C.; Dargenio, M.; Chiaretti, S.; Skert, C.; Giglio, F.; Trappolini, S.; Fracchiolla, N.S.; et al. Ponatinib as a Prophylactic or Pre-Emptive Strategy to Prevent Cytological Relapse after Allogeneic Stem Cell Transplantation in Patients with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia Transplanted in Complete Cytological Remission. Cancers 2024, 16, 2108. https://doi.org/10.3390/cancers16112108
Candoni A, Chiusolo P, Lazzarotto D, Sartor C, Dargenio M, Chiaretti S, Skert C, Giglio F, Trappolini S, Fracchiolla NS, et al. Ponatinib as a Prophylactic or Pre-Emptive Strategy to Prevent Cytological Relapse after Allogeneic Stem Cell Transplantation in Patients with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia Transplanted in Complete Cytological Remission. Cancers. 2024; 16(11):2108. https://doi.org/10.3390/cancers16112108
Chicago/Turabian StyleCandoni, Anna, Patrizia Chiusolo, Davide Lazzarotto, Chiara Sartor, Michelina Dargenio, Sabina Chiaretti, Cristina Skert, Fabio Giglio, Silvia Trappolini, Nicola Stefano Fracchiolla, and et al. 2024. "Ponatinib as a Prophylactic or Pre-Emptive Strategy to Prevent Cytological Relapse after Allogeneic Stem Cell Transplantation in Patients with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia Transplanted in Complete Cytological Remission" Cancers 16, no. 11: 2108. https://doi.org/10.3390/cancers16112108
APA StyleCandoni, A., Chiusolo, P., Lazzarotto, D., Sartor, C., Dargenio, M., Chiaretti, S., Skert, C., Giglio, F., Trappolini, S., Fracchiolla, N. S., Medici, S., Bresciani, P., Cuoghi, A., & Papayannidis, C. (2024). Ponatinib as a Prophylactic or Pre-Emptive Strategy to Prevent Cytological Relapse after Allogeneic Stem Cell Transplantation in Patients with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia Transplanted in Complete Cytological Remission. Cancers, 16(11), 2108. https://doi.org/10.3390/cancers16112108