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Pichler H, Sedlacek P, Meisel R, Beier R, Faraci M, Kalwak K, Ifversen M, Müller I, Stein J, Vettenranta K, Kropshofer G, Kolenova A, Karlhuber S, Glogova E, Poetschger U, Peters C, Suttorp M, Matthes-Leodolter S, Balduzzi A. Haematopoietic stem cell transplantation after reduced intensity conditioning in children and adolescents with chronic myeloid leukaemia: A prospective multicentre trial of the I-BFM Study Group. Br J Haematol 2024. [PMID: 38803040 DOI: 10.1111/bjh.19535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
This prospective multicentre trial evaluated the safety and the efficacy of a thiotepa/melphalan-based reduced intensity conditioning (RIC) haematopoietic stem cell transplantation (HSCT) in children and adolescents with chronic myeloid leukaemia (CML) in chronic phase (CP). Thirty-two patients were transplanted from matched siblings or matched unrelated donors. In 22 patients, HSCT was performed due to insufficient molecular response or loss of response to first- or second-generation tyrosine kinase inhibitor (TKI), with pretransplant BCR::ABL1 transcripts ranging between 0.001% and 33%. The protocol included a BCR::ABL1-guided intervention with TKI retreatment in the first year and donor lymphocyte infusions (DLI) in the second-year post-transplant. All patients engrafted. The 1-year transplant-related mortality was 3% (confidence interval [CI]: 0%-6%). After a median follow-up of 6.3 years, 5-year overall survival and event-free survival are 97% (CI: 93%-100%) and 91% (CI: 79%-100%) respectively. The current 5-year leukaemia-free survival with BCR::ABL1 <0.01% is 97% (CI: 88%-100%) and the current TKI- and DLI-free survival is 95% (CI: 85%-100%). The incidence of chronic graft-versus-host disease (GvHD) was 32%, being severe in four patients (13%). At last follow-up, 31 patients are GvHD-free and have stopped immunosuppression. RIC HSCT following pretreatment with TKI is feasible and effective in children and adolescents with CP-CML with an excellent disease-free and TKI-free survival.
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Affiliation(s)
- Herbert Pichler
- Department of Paediatric Haematology and Oncology, St. Anna Children's Hospital, Vienna, Austria
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Children's Cancer Research Institute, Medical University of Vienna, Vienna, Austria
| | - Petr Sedlacek
- Department of Paediatric Haematology and Oncology, University Hospital Motol, Charles University, Prague, Czech Republic
| | - Roland Meisel
- Division of Pediatric Stem Cell Therapy, Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Rita Beier
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Maura Faraci
- Hematopoietic Stem Cell Transplantation Unit, Department of Hematology and Oncology, IRCCS Institute G. Gaslini, Genoa, Italy
| | - Krzysztof Kalwak
- Clinical Department of Paediatric Bone Marrow Transplantation, Oncology and Haematology, Wrocław Medical University, Wrocław, Poland
| | - Marianne Ifversen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ingo Müller
- Division of Pediatric Stem Cell Transplantation and Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jerry Stein
- Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Kim Vettenranta
- Paediatric Haemato-Oncology, University of Helsinki, Helsinki, Finland
| | - Gabriele Kropshofer
- Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexandra Kolenova
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Children's Haematology and Oncology Clinic, Comenius University in Bratislava, Bratislava, Slovakia
| | - Susanne Karlhuber
- Children's Cancer Research Institute, Medical University of Vienna, Vienna, Austria
| | - Evgenia Glogova
- Children's Cancer Research Institute, Medical University of Vienna, Vienna, Austria
| | - Ulrike Poetschger
- Department of Paediatric Haematology and Oncology, St. Anna Children's Hospital, Vienna, Austria
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Children's Cancer Research Institute, Medical University of Vienna, Vienna, Austria
| | - Christina Peters
- Department of Paediatric Haematology and Oncology, St. Anna Children's Hospital, Vienna, Austria
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Children's Cancer Research Institute, Medical University of Vienna, Vienna, Austria
| | - Meinolf Suttorp
- Paediatric Haemato-Oncology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Susanne Matthes-Leodolter
- Department of Paediatric Haematology and Oncology, St. Anna Children's Hospital, Vienna, Austria
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Children's Cancer Research Institute, Medical University of Vienna, Vienna, Austria
| | - Adriana Balduzzi
- Pediatric Transplant Unit, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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2
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Brioli A, Lomaia E, Fabisch C, Sacha T, Klamova H, Morozova E, Golos A, Ernst P, Olsson-Stromberg U, Zackova D, Nicolini FE, Bao H, Castagnetti F, Patkowska E, Mayer J, Hirschbühl K, Podgornik H, Paczkowska E, Parry A, Ernst T, Voskanyan A, Szczepanek E, Saussele S, Franke GN, Kiani A, Faber E, Krause S, Casado LF, Lewandowski K, Eder M, Anhut P, Gil J, Südhoff T, Hebart H, Heibl S, Pfirrmann M, Hochhaus A, Lauseker M. Management and outcome of patients with chronic myeloid leukemia in blast phase in the tyrosine kinase inhibitor era - analysis of the European LeukemiaNet Blast Phase Registry. Leukemia 2024; 38:1072-1080. [PMID: 38548962 DOI: 10.1038/s41375-024-02204-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/15/2024] [Accepted: 02/23/2024] [Indexed: 05/08/2024]
Abstract
Blast phase (BP) of chronic myeloid leukemia (CML) still represents an unmet clinical need with a dismal prognosis. Due to the rarity of the condition and the heterogeneity of the biology and clinical presentation, prospective trials and concise treatment recommendations are lacking. Here we present the analysis of the European LeukemiaNet Blast Phase Registry, an international collection of the clinical presentation, treatment and outcome of blast phases which had been diagnosed in CML patients after 2015. Data reveal the expected heterogeneity of the entity, lacking a clear treatment standard. Outcomes remain dismal, with a median overall survival of 23.8 months (median follow up 27.8 months). Allogeneic stem cell transplantation (alloSCT) increases the rate of deep molecular responses. De novo BP and BP evolving from a previous CML do show slightly different features, suggesting a different biology between the two entities. Data show that outside clinical trials and in a real-world setting treatment of blast phase is individualized according to disease- and patient-related characteristics, with the aim of blast clearance prior to allogeneic stem cell transplantation. AlloSCT should be offered to all patients eligible for this procedure.
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MESH Headings
- Humans
- Blast Crisis/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Registries
- Protein Kinase Inhibitors/therapeutic use
- Middle Aged
- Male
- Adult
- Female
- Aged
- Young Adult
- Transplantation, Homologous
- Europe
- Hematopoietic Stem Cell Transplantation/methods
- Prognosis
- Adolescent
- Treatment Outcome
- Survival Rate
- Disease Management
- Follow-Up Studies
- Tyrosine Kinase Inhibitors
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Affiliation(s)
- Annamaria Brioli
- Klinik und Poliklinik für Innere Medizin C, Hämatologie und Onkologie, Universitätsmedizin Greifswald, Greifswald, Germany.
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Comprehensive Cancer Center Central Germany, Campus Jena, Jena, Germany.
- Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany.
| | - Elza Lomaia
- Research Department of Immuno-Oncology, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Christian Fabisch
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Comprehensive Cancer Center Central Germany, Campus Jena, Jena, Germany
| | - Tomasz Sacha
- Department of Hematology, Jagiellonian University Medical College, Krakow, Poland
| | - Hana Klamova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Elena Morozova
- Raisa Gorbacheva memorial Research Institute for Pediatric Oncology, Hematology, Transplantation, First State Pavlov Medical University of Saint Petersburg, Saint Petersburg, Russian Federation
| | - Aleksandra Golos
- Hematooncology Department, Copernicus Memorial Hospital, Lodz, Poland
| | - Philipp Ernst
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Comprehensive Cancer Center Central Germany, Campus Jena, Jena, Germany
| | | | - Daniela Zackova
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Franck E Nicolini
- Centre Léon Bérard, Hématology Départment and CRCL INSERM U590, Lyon, France
| | - Han Bao
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Medizinische Fakultät, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Fausto Castagnetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Elzbieta Patkowska
- Hematology Department, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Jiri Mayer
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Klaus Hirschbühl
- Hematology and Oncology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Helena Podgornik
- Department of Haematology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Edyta Paczkowska
- Department of General Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Anne Parry
- Centre Hospitalier Annecy Genevois, Annecy, France
| | - Thomas Ernst
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Comprehensive Cancer Center Central Germany, Campus Jena, Jena, Germany
| | | | - Elzbieta Szczepanek
- Department of Hematology, Jagiellonian University Medical College, Cracow, Poland
| | - Susanne Saussele
- III. Med. Klinik, Med. Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Georg-Nikolaus Franke
- University of Leipzig Medical Center, Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Diseases, Comprehensive Cancer Center Central Germany, Campus Leipzig, Leipzig, Germany
| | - Alexander Kiani
- Medizinische Klinik IV, Klinikum Bayreuth GmbH, Bayreuth, and Comprehensive Cancer Center Erlangen-EMN, Bayreuth, Germany
| | - Edgar Faber
- Department of Hemato-Oncology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University in Olomouc, Olomouc, Czech Republic
| | - Stefan Krause
- Uniklinik Erlangen, Medizinische Klinik 5, Erlangen, Germany
| | - Luis Felipe Casado
- Servicio de Hematología, Hospital General Universitario de Toledo, Toledo, Spain
| | - Krzysztof Lewandowski
- Department of Hematology & Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Matthias Eder
- Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany
| | - Peter Anhut
- Onkologische Schwerpunktpraxis Anhut, Kronach, Germany
| | - Justyna Gil
- Oncology Centre of the Podkarpackie Province, Department of Hematooncology, Brzozow, Poland
| | - Thomas Südhoff
- Klinikum Passau, Klinik für Onkologie, Hämatologie und Palliativmedizin, Passau, Germany
| | - Holger Hebart
- Zentrum für Innere Medizin, Hämatologie/Onkologie, Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany
| | - Sonja Heibl
- Abteilung für Innere Medizin IV, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Markus Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Medizinische Fakultät, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Comprehensive Cancer Center Central Germany, Campus Jena, Jena, Germany
| | - Michael Lauseker
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Medizinische Fakultät, Ludwig-Maximilians-Universität München, Munich, Germany.
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3
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Hu S, Jabbour EJ, Hu CY, Tang G, Wang W, Medeiros LJ, Bueso-Ramos C. Recurrent lymphoid and myeloid relapses due to treatment cessations reveal natural history of Ph-positive B-ALL and pose a diagnostic challenge. Am J Hematol 2024; 99:721-726. [PMID: 38240333 DOI: 10.1002/ajh.27210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/06/2023] [Accepted: 01/01/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Elias J Jabbour
- Departments of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Collin Y Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carlos Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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4
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Sutton KM, Wiggins M, Zaragoza R, Swamy S. Chronic spontaneous urticaria as the presenting feature in a paediatric case of chronic myeloid leukaemia. Pediatr Blood Cancer 2024; 71:e30846. [PMID: 38185755 DOI: 10.1002/pbc.30846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Kathryn M Sutton
- Department of Clinical Immunology and Allergy, Royal North Shore Hospital (RNSH), Sydney, New South Wales, Australia
| | - Meredith Wiggins
- Department of Haematology, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Randwick, New South Wales, Australia
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Reina Zaragoza
- Department of Clinical Immunology and Allergy, Royal North Shore Hospital (RNSH), Sydney, New South Wales, Australia
| | - Shruti Swamy
- Department of Clinical Immunology and Allergy, Royal North Shore Hospital (RNSH), Sydney, New South Wales, Australia
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Central Clinical School, University Sydney School of Medicine, Sydney, New South Wales, Australia
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Menger JM, Sathianathen RS, Sakamoto KM, Hijiya N. BCR/ABL-Positive Chronic Myeloid Leukemia in Children: Current Treatment Approach. Curr Oncol Rep 2024; 26:250-257. [PMID: 38340217 DOI: 10.1007/s11912-024-01502-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the most updated treatment recommendations for pediatric CML, and to discuss current areas of investigation. RECENT FINDINGS There is new phase 1 data to support the safety of the non-ATP competitive tyrosine kinase inhibitor (TKI) asciminib in the pediatric cohort. Ongoing studies are investigating the role of treatment-free remission in children. Chronic phase CML in children is managed with lifelong TKI therapy; however, evidence of deeper remissions sustained with second-generation TKIs may permit shorter treatment courses. Use of more specific TKIs may mitigate some of the side effects specific to the pediatric cohort. Children with advanced phase CML should achieve a complete hematologic remission with use of a second-generation TKI prior to transplant to achieve the best outcome.
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Affiliation(s)
- Jenna M Menger
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, 10069, USA.
| | | | - Kathleen M Sakamoto
- Division of Hematology/Oncology, Department of Pediatrics, Stanford University, Stanford, CA, 94305, USA
| | - Nobuko Hijiya
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, 10069, USA
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Ata F, Benkhadra M, Ghasoub R, Fernyhough LJ, Omar NE, Nashwan AJ, Aldapt MB, Mushtaq K, Kassem NA, Yassin MA. Tyrosine Kinase Inhibitors in pediatric chronic myeloid leukemia: a focused review of clinical trials. Front Oncol 2023; 13:1285346. [PMID: 38188307 PMCID: PMC10769570 DOI: 10.3389/fonc.2023.1285346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024] Open
Abstract
Tyrosine Kinase Inhibitors (TKIs) is revolutionizing the management of pediatric Chronic Myeloid Leukemia (CML), offering alternatives to Allogeneic Hematopoietic Stem Cell Transplantation (AHSCT). We conducted a comprehensive review of 16 Randomized Controlled Trials (RCTs) encompassing 887 pediatric CML patients treated with TKIs including Imatinib, Dasatinib, and Nilotinib. The median patient age ranged from 6.5 to 14 years, with a median white blood cell count of 234 x 10^9/uL, median hemoglobin level of 9.05 g/dL, and median platelet count of 431.5 x 10^9/µL. Imatinib seems to be predominant first line TKI, with the most extensive safety and efficacy data. BCR::ABL response rates below 10% ranged from 60% to 78%, CCyR at 24 months ranged from 62% to 94%, and PFS showed variability from 56.8% to 100%, albeit with differing analysis timepoints. The Safety profile of TKIs was consistent with the known safety profile in adults. With the availability of three TKIs as first line options, multiple factors should be considered when selecting first line TKI, including drug formulation, administration, comorbidities, and financial issues. Careful monitoring of adverse events, especially in growing children, should be considered in long term follow-up clinical trials.
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Affiliation(s)
- Fateen Ata
- Department of Endocrinology and Metabolism, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Maria Benkhadra
- Pharmacy Department, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Rola Ghasoub
- Pharmacy Department, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Liam J. Fernyhough
- Department of Medical Education, Weill Cornell Medicine Qatar, Doha, Qatar
| | - Nabil E. Omar
- Pharmacy Department, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Health Sciences Program, Clinical and Population Health Research, College of Pharmacy, Qatar University, Doha, Qatar
| | | | - Mahmood B. Aldapt
- Department of Medicine, Unity Hospital/Rochester Regional Health, Rochester, NY, United States
| | - Kamran Mushtaq
- Department of Gastroenterology, University Hospital Southampton, Southampton, United Kingdom
| | - Nancy A. Kassem
- Pharmacy Department, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A. Yassin
- Department of Medical Oncology/Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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Shumock SS, Temple WC, Marinoff A, Aaronson K, Southworth E, Xirenayi S, Lee AG, Leung SG, Sweet‐Cordero EA, Hermiston M, Higham C, Stieglitz E. Pre-and post-HSCT use of TKI therapy for fusion-driven B-ALL: A case series of five pediatric, adolescent and young adult patients. Cancer Rep (Hoboken) 2023; 6:e1901. [PMID: 37933765 PMCID: PMC10728537 DOI: 10.1002/cnr2.1901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/07/2023] [Accepted: 08/27/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND The development of tyrosine kinase inhibitors (TKIs) has significantly improved survival rates among patients with Philadelphia chromosome (Ph+) B cell acute lymphoblastic leukemia (B-ALL). Ph-like B-ALL patients lack the BCR::ABL1 translocation but share gene expression profiles with Ph+ B-ALL. The role of TKIs for Ph-like patients pre- and post-hematopoietic stem cell transplantation (HSCT) is not yet clear. CASE Here we present five cases of pediatric, adolescent, and young adult patients who presented with Ph-like B-ALL or CML in B-ALL blast phase who were treated with personalized TKI regimens pre- and post-HSCT. CONCLUSION This report describes several novel Ph-like fusions as well as combinations of TKIs with chemotherapy or immunotherapy not yet reported in the pediatric population. This case series provides real-world experience highlighting the potential application of pre- and post-HSCT use of TKIs in a subset of patients with targetable fusions.
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Affiliation(s)
| | - William C. Temple
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - Amanda Marinoff
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - Kathryn Aaronson
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - Erica Southworth
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - Simayijiang Xirenayi
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - Alex G. Lee
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - Stanley G. Leung
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - E. Alejandro Sweet‐Cordero
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - Michelle Hermiston
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - Christine Higham
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
| | - Elliot Stieglitz
- Department of PediatricsBenioff Children's Hospitals, University of California, San FranciscoCaliforniaUSA
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