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Li J, Lu A, Gao Y, Wan Y, Wang J, Zhang J, Hu T, Wu P, Chen X, Zou Y, Chen Y, Zhang L, Guo Y, Yang W, Li C, Zhang Y, Zhu X. Minimal residual disease monitoring in childhood Philadelphia chromosome-positive acute lymphoblastic leukemia: prognostic significance and correlation between multiparameter flow cytometry and real-time quantitative polymerase chain reaction. Haematologica 2024; 109:4089-4094. [PMID: 38695139 PMCID: PMC11609813 DOI: 10.3324/haematol.2024.285119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/19/2024] [Indexed: 05/07/2024] Open
Abstract
Not available.
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Affiliation(s)
- Jun Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Anni Lu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Yangyang Gao
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Yang Wan
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Junxia Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Jingliao Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Tianyuan Hu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Peng Wu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Xiaojuan Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Yao Zou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Yumei Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Li Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Ye Guo
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Wenyu Yang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Chengwen Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Yingchi Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600
| | - Xiaofan Zhu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600.
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2
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Kramp LJ, Heydrich-Karsten C, Sembill S, Karow A, Lion T, Chitadze G, Suttorp M, Cario G, Metzler M. CAR-T cells for the treatment of pediatric chronic myeloid leukemia in repeatedly relapsed lymphoid blast phase. Ann Hematol 2024; 103:4811-4815. [PMID: 39304585 PMCID: PMC11535078 DOI: 10.1007/s00277-024-06011-4] [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: 07/30/2024] [Accepted: 09/12/2024] [Indexed: 09/22/2024]
Abstract
Chronic myeloid leukemia presenting de novo in the blast phase (CML-BP) is a rare diagnosis among pediatric malignancies. We report on a 16-year-old male who presented with CML-BP lymphoid at diagnosis. He was treated with shortened acute lymphoblastic leukemia induction plus the tyrosine kinase inhibitor (TKI) imatinib followed by dasatinib. After achieving molecular remission (MR), hematopoietic stem cell transplantation (HSCT) was performed early after diagnosis. Despite prophylactic dasatinib, he relapsed 3 months later with the kinase domain mutation T315I. Multiple therapeutic approaches including ponatinib, blinatumomab, a 2nd HSCT from a different donor, donor lymphocyte infusions, and high-dose asciminib all resulted in subsequent relapse. Another molecular response was achieved by combining ponatinib plus asciminib with chemotherapy. In this situation, CD19-directed CAR-T cells (Kymriah®) were administered for compassionate use and tolerated without adverse events. Compared to all prior therapies, CAR T-cells maintained remission. After 12 months of follow-up, complete B-cell aplasia and low numbers of CAR-T cells are detectable in the peripheral blood, potentially mediating long-term disease control.
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Affiliation(s)
- Laura-Jane Kramp
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Medical Center Schleswig-Holstein Kiel, Kiel, Germany
| | - Christiane Heydrich-Karsten
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Medical Center Schleswig-Holstein Kiel, Kiel, Germany
| | - Stephanie Sembill
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Axel Karow
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Thomas Lion
- St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
| | - Guranda Chitadze
- Clinical Research Unit CATCH-ALL (KFO, German Research Foundation), Christian- Albrechts-University of Kiel, Kiel, Germany
- Medical Department II, Hematology and Oncology, Christian-Albrechts University of Kiel, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Meinolf Suttorp
- Pediatric Hemato-Oncology, Medical Faculty, Technical University Dresden, Dresden, Germany
| | - Gunnar Cario
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Medical Center Schleswig-Holstein Kiel, Kiel, Germany
- Clinical Research Unit CATCH-ALL (KFO, German Research Foundation), Christian- Albrechts-University of Kiel, Kiel, Germany
| | - Markus Metzler
- Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054, Erlangen, Germany.
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
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3
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Zheng FY, Lu AD, Jia YP, Zuo YX, Zeng HM, Jiang Q, Zhang LP. [Research on the clinical characteristics and prognosis of children with chronic myeloid leukemia in the blast phase]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2024; 45:931-936. [PMID: 39622757 PMCID: PMC11579757 DOI: 10.3760/cma.j.cn121090-20240130-00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Indexed: 12/06/2024]
Abstract
Objective: To explore the clinical characteristics and prognosis of children with chronic myeloid leukemia in the blast phase (CML-BP) . Methods: The clinical characteristics, treatment measures, and survival outcomes of 28 children with CML-BP were analyzed in our hospital from January 2008 to November 2022. Results: The male to female ratio of the 28 children with CML-BP was 1.15∶1. The median age of diagnosis of CML-BP was 10 years, and the median follow-up time was 79 months. During the diagnosis of CML, four children were in the BP, one was in the accelerated phase (AP) and 23 children were in the chronic phase (CP). Among the 23 children with CML-CP, 75% had progressed directly from CP to BP without experiencing the AP. Among the children diagnosed with CML-BP, 71.4% were classified as chronic myeloid leukemia lymphoid blast phase (CML-LBP), 25.0% belonged to the chronic myeloid leukemia myeloid blast phase (CML-MBP), and 3.6% belonged to the chronic myeloid leukemia mixed phenotype acute leukemia (CML-MPAL). Treatment with hemaopoietic stem cell transplantation (HSCT) after tyosine kinase inhibitor (TKI) combined with chemotherapy was administered to 19 children, two children received HSCT after TKI alone, and seven children received TKI combined with chemotherapy but without HSCT. The 5-year overall survival of the 28 children with CML-BP was 59.3%. Conclusion: The direct progression of BP from CP is greater in children with CML-BP compared with adults, and the overall prognosis of children with CML-BP is poor.
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Affiliation(s)
- F Y Zheng
- Peking University People's Hospital, Department of Pediatrics, Beijing 100044, China
| | - A D Lu
- Peking University People's Hospital, Department of Pediatrics, Beijing 100044, China
| | - Y P Jia
- Peking University People's Hospital, Department of Pediatrics, Beijing 100044, China
| | - Y X Zuo
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China
| | - H M Zeng
- Peking University People's Hospital, Department of Pediatrics, Beijing 100044, China
| | - Q Jiang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China
| | - L P Zhang
- Peking University People's Hospital, Department of Pediatrics, Beijing 100044, China
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4
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Krumbholz M, Dolnik A, Sträng E, Ghete T, Skambraks S, Hutter S, Simonis A, Stegelmann F, Suttorp M, Horn AHC, Sticht H, Haferlach T, Bullinger L, Metzler M. A high proportion of germline variants in pediatric chronic myeloid leukemia. Mol Cancer 2024; 23:206. [PMID: 39327604 PMCID: PMC11426096 DOI: 10.1186/s12943-024-02109-5] [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: 07/17/2024] [Accepted: 09/02/2024] [Indexed: 09/28/2024] Open
Abstract
Chronic myeloid leukemia (CML) typically occurs in late adulthood. Pediatric CML is a rare form of leukemia. In all age groups, the characteristic genetic driver of the disease is the BCR::ABL1 fusion gene. However, additional genomic events contribute to leukemic transformation, which is not yet well-characterized in pediatric CML. We investigated the mutational landscape of pediatric CML to determine whether predisposing germline variants may play a role in early-age disease development. Whole exome sequencing and targeted sequencing were performed in pediatric and adult CML samples to identify age-related germline and somatic variants in addition to the BCR::ABL1 translocation. Germline variants were detected in about 60% of pediatric patients with CML, with predominantly hematopoietic genes affected, most frequently ASXL1, NOTCH1, KDM6B, and TET2. The number of germline variants was significantly lower in adult patients with CML. If only confirmed pathogenic variants were regarded as cancer-predisposing variants, the occurrence was ~ 10% of pediatric CML, which is comparable to other hematological malignancies and most childhood cancer entities in general. We hypothesize that the interaction with the strong oncogene BCR::ABL1 may also favor the development of leukemia by weaker variants in the same genes. In pediatric patients, the germline variants of genes associated with clonal hematopoiesis may increase the likelihood that an incidental BCR::ABL1 translocation triggers the early manifestation of CML.
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Affiliation(s)
- Manuela Krumbholz
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Loschgestrasse 15, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Anna Dolnik
- Department of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Eric Sträng
- Department of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Tabita Ghete
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Loschgestrasse 15, 91054, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Sabrina Skambraks
- Department of Internal Medicine III, Ulm University Hospital, Ulm, Germany
| | | | - Alfred Simonis
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Frank Stegelmann
- Department of Internal Medicine III, Ulm University Hospital, Ulm, Germany
| | - Meinolf Suttorp
- Medical Faculty, Pediatric Hematology and Oncology, Technical University, Dresden, Germany
| | - Anselm H C Horn
- Bioinformatics, Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
- Erlangen National High Performance Computing Center (NHR@FAU), Friedrich-Alexander- Universität Erlangen-Nürnberg, 91058, Erlangen, Germany
| | - Heinrich Sticht
- Bioinformatics, Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
| | | | - Lars Bullinger
- Department of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Berlin, Germany
- Corporate member of Freie Universität Berlin and Humboldt, partner site Berlin, Universitätsmedizin Berlin, Universität zu Berlin, German Cancer Consortium (DKTK), Berlin, Germany
| | - Markus Metzler
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Loschgestrasse 15, 91054, Erlangen, Germany.
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany.
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5
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Tito Rodriguez PR, Mehta D, Subhan M, Yadav RP, Yousofzai BS, Al-Najjar EH, Bibi R, Idries M, Singh A, Adnan M. Evolving Horizons in Pediatric Leukemia: Novel Insights, Challenges, and the Journey Ahead. Cureus 2024; 16:e67480. [PMID: 39310608 PMCID: PMC11415937 DOI: 10.7759/cureus.67480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2024] [Indexed: 09/25/2024] Open
Abstract
Pediatric leukemia, encompassing acute lymphoblastic leukemia (ALL) and acute myeloid leukemia, remains a formidable challenge despite significant treatment advancements. This review examines recent developments in immunotherapy, chemotherapy, and bone marrow transplantation for pediatric leukemia through a comprehensive analysis of recent literature, focusing on critical studies and clinical trials. Immunotherapy, including monoclonal antibodies, such as blinatumomab and inotuzumab ozogamicin, and chimeric antigen receptor T-cell therapies, such as tisagenlecleucel and brexucabtagene autoleucel, have demonstrated promising results in relapsed or refractory B-cell ALL (B-ALL), achieving notable remission rates with manageable side effects. Chemotherapy continues to be the primary treatment, utilizing multiphase regimens tailored to individual risk profiles. Bone marrow transplantation, especially allogeneic stem cell transplantation, offers potential cures for high-risk or relapsed cases, though it poses risks including graft-versus-host disease and infections. Despite these advancements, treatment resistance, toxicity, and accessibility persist. This review also discusses the long-term outcomes among pediatric leukemia survivors, focusing on late-onset side effects associated with treatments such as chemotherapy and bone marrow transplantation, encompassing secondary malignancies, organ dysfunction, and neurocognitive impacts. Ongoing research and clinical trials are crucial to refine these therapies, enhance their efficacy, and reduce adverse effects, ultimately improving young patients' survival and quality of life.
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Affiliation(s)
| | - Deepalee Mehta
- Internal Medicine, Bharati Vidyapeeth Medical College, Sangli, Sangli, IND
| | - Muhammad Subhan
- Medicine, Allama Iqbal Medical College, Jinnah Hospital, Lahore, PAK
| | | | | | | | - Ruqiya Bibi
- Medicine, Allama Iqbal Medical College, Jinnah Hospital, Lahore, PAK
| | - Mohamed Idries
- Biochemistry, St. George's University School of Medicine, St. George's, GRD
| | - Atinder Singh
- Medicine, World College of Medical Sciences and Research Hospital, Gurugram, IND
| | - Muhammad Adnan
- Pediatrics, Lady Reading Hospital, Peshawar, PAK
- Pediatrics, Khyber Medical College, Peshawar, PAK
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6
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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; 205:268-279. [PMID: 38803040 DOI: 10.1111/bjh.19535] [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] [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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7
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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 PMCID: PMC11073984 DOI: 10.1038/s41375-024-02204-y] [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] [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
- Adolescent
- Adult
- Aged
- Female
- Humans
- Male
- Middle Aged
- Young Adult
- Blast Crisis/pathology
- Disease Management
- Europe
- Follow-Up Studies
- Hematopoietic Stem Cell Transplantation/methods
- 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
- Prognosis
- Registries
- Survival Rate
- Transplantation, Homologous
- Treatment Outcome
- Tyrosine Kinase Inhibitors/therapeutic use
- Aged, 80 and over
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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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8
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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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9
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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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10
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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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11
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Katsarou D, Kotanidou EP, Tsinopoulou VR, Tragiannidis A, Hatzipantelis E, Galli-Tsinopoulou A. Impact of Tyrosine Kinase Inhibitors (TKIs) on Growth in Children and Adolescents with Chronic Myeloid Leukemia: A Systematic Review. Curr Pharm Des 2024; 30:2631-2642. [PMID: 39005125 DOI: 10.2174/0113816128309071240626114308] [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] [Received: 02/06/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Chronic Myeloid Leukemia (CML) is a rare myeloproliferative disease in childhood. Treatment in CML includes Tyrosine Kinase Inhibitors (TKIs), which inhibit the cytoplasmic kinase BCR/ABL. Tyrosine kinases play a key role in the secretion of growth hormone and insulin-like growth factor 1 (IGF-1). OBJECTIVE The aim of this systematic review was to study the effect of TKIs on the growth of children and adolescents with CML. METHODS English-language publications were searched in the PubMed/Cochrane library/Google Scholar databases (2002-2023), and retrieved studies were assessed according to PRISMA-Statement and Newcastle- Ottawa-scale. RESULTS The search strategy yielded 1066 articles. After applying the inclusion/exclusion criteria, 941 were excluded based on title screening and 111 on abstract review. The systematic review included 14 articles (11 retrospective observational studies/3 clinical trials). Twelve studies reported data on the prevalence of growth disorders after the administration of 1st generation TKIs (imatinib). Two studies reported a negative effect of 2nd generation TKIs (dasatinib/nilotinib) on physical growth. Four studies recorded a decrease in height z-score after treatment compared to baseline. Two 1st-generation TKIs studies reported data on children's final height; one reported restoration of final height to normal after the onset of puberty, despite initial slowing, and the final height was lower than mid-parental target height. Serum IGF-1 levels were reported in 2 studies to be within normal range, while in 3 studies, a significant decrease was documented. Considerable study heterogeneity was observed related to dosage/duration of treatment/disease phase/stage of puberty/ethnicity. CONCLUSION A negative effect of TKIs on the growth and final height of children was noted.
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Affiliation(s)
- Dimitra Katsarou
- Program of Postgraduate Studies "Adolescent Medicine and Adolescent Health Care", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, 54636, Greece
| | - Eleni P Kotanidou
- Program of Postgraduate Studies "Adolescent Medicine and Adolescent Health Care", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Vasiliki Rengina Tsinopoulou
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Athanasios Tragiannidis
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Emmanouil Hatzipantelis
- Program of Postgraduate Studies "Adolescent Medicine and Adolescent Health Care", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Assimina Galli-Tsinopoulou
- Program of Postgraduate Studies "Adolescent Medicine and Adolescent Health Care", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
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12
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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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13
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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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