• Blood · Feb 2007

    Clinical Trial

    Imatinib combined with induction or consolidation chemotherapy in patients with de novo Philadelphia chromosome-positive acute lymphoblastic leukemia: results of the GRAAPH-2003 study.

    • Adrienne de Labarthe, Philippe Rousselot, Françoise Huguet-Rigal, Eric Delabesse, Francis Witz, Sébastien Maury, Delphine Réa, Jean-Michel Cayuela, Marie-Christine Vekemans, Oumedaly Reman, Agnès Buzyn, Arnaud Pigneux, Martine Escoffre, Yves Chalandon, Elizabeth MacIntyre, Véronique Lhéritier, Jean-Paul Vernant, Xavier Thomas, Norbert Ifrah, Hervé Dombret, and Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL).
    • Department of Hematology, Hôpital Saint-Louis, Paris, France, and Department of Hematology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.
    • Blood. 2007 Feb 15; 109 (4): 1408-13.

    AbstractThe combination of imatinib with chemotherapy has been recently reported as very promising in patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). During 2004 and 2005, 45 patients with newly diagnosed Ph+ ALL were treated in the Group for Research on Adult Acute Lymphoblastic Leukemia (GRAAPH) 2003 study, in which imatinib was started with HAM (mitoxantrone with intermediate-dose cytarabine) consolidation in good early responders (corticosensitive and chemosensitive ALL) or earlier during the induction course in combination with dexamethasone and vincristine in poor early responders (corticoresistant and/or chemoresistant ALL). Imatinib was then continuously administered until stem cell transplantation (SCT). Overall, complete remission (CR) and BCR-ABL real-time quantitative polymerase chain reaction (RQ-PCR) negativity rates were 96% and 29%, respectively. All of the 22 CR patients (100%) with a donor actually received allogeneic SCT in first CR. At 18 months, the estimated cumulative incidence of relapse, disease-free survival, and overall survival were 30%, 51%, and 65%, respectively. These 3 end points compared very favorably with results obtained in the pre-imatinib LALA-94 trial. This study confirms the value of the combined approach and encourages prospective trials to define the optimal chemotherapy that has to be combined with imatinib and to carefully reevaluate the place of allogeneic SCT in this new context.

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