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FLAG-idarubicin and allogeneic stem cell transplantation for Ph-positive ALL beyond first remission.
Bone Marrow Transplant. 1998 Dec; 22(12):1137-43.BM

Abstract

We describe a single centre experience of eight consecutive patients with relapsed or refractory Ph+ ALL treated with the FLAG/idarubicin regimen followed by BMT or PBSCT. Following FLAG/idarubicin, one achieved a partial response and seven CR. All patients subsequently received allogeneic transplants: one sibling BMT, three matched unrelated (MUD) BMT and four sibling PBSCT. Two patients received second transplants with PBSC from their original BM donors following FLA/Ida with no further conditioning. Three patients are alive in CR 9, 24 and 32 months after transplant. Seven of eight patients had a cytogenetic response following FLAG/Ida induction and one of seven became bcr-abl negative. All eight patients had a complete cytogenetic response following transplant. Four of five assessable patients became p190 bcr-abl negative after transplant; three of these subsequently relapsed. Both patients with the p210 bcr-abl transcript remained bcr-abl positive in CR after transplant. FLAG/Ida was well tolerated and appears to be effective in inducing remission in relapsed Ph+ ALL. The use of FDR-containing chemotherapy without further conditioning prior to PBSCT deserves further study in heavily pre-treated patients and, in patients with relapsed ALL following BMT, may be a safer option than DLI (donor lymphocyte infusion) by avoiding the associated risk of aplasia.

Authors+Show Affiliations

Department of Haematology, Norfolk and Norwich Hospital, Norwich, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9894715

Citation

Deane, M, et al. "FLAG-idarubicin and Allogeneic Stem Cell Transplantation for Ph-positive ALL Beyond First Remission." Bone Marrow Transplantation, vol. 22, no. 12, 1998, pp. 1137-43.
Deane M, Koh M, Foroni L, et al. FLAG-idarubicin and allogeneic stem cell transplantation for Ph-positive ALL beyond first remission. Bone Marrow Transplant. 1998;22(12):1137-43.
Deane, M., Koh, M., Foroni, L., Galactowicz, G., Hoffbrand, A. V., Lawler, M., Secker-Walker, L., & Prentice, H. G. (1998). FLAG-idarubicin and allogeneic stem cell transplantation for Ph-positive ALL beyond first remission. Bone Marrow Transplantation, 22(12), 1137-43.
Deane M, et al. FLAG-idarubicin and Allogeneic Stem Cell Transplantation for Ph-positive ALL Beyond First Remission. Bone Marrow Transplant. 1998;22(12):1137-43. PubMed PMID: 9894715.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - FLAG-idarubicin and allogeneic stem cell transplantation for Ph-positive ALL beyond first remission. AU - Deane,M, AU - Koh,M, AU - Foroni,L, AU - Galactowicz,G, AU - Hoffbrand,A V, AU - Lawler,M, AU - Secker-Walker,L, AU - Prentice,H G, PY - 1999/1/23/pubmed PY - 1999/1/23/medline PY - 1999/1/23/entrez SP - 1137 EP - 43 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 22 IS - 12 N2 - We describe a single centre experience of eight consecutive patients with relapsed or refractory Ph+ ALL treated with the FLAG/idarubicin regimen followed by BMT or PBSCT. Following FLAG/idarubicin, one achieved a partial response and seven CR. All patients subsequently received allogeneic transplants: one sibling BMT, three matched unrelated (MUD) BMT and four sibling PBSCT. Two patients received second transplants with PBSC from their original BM donors following FLA/Ida with no further conditioning. Three patients are alive in CR 9, 24 and 32 months after transplant. Seven of eight patients had a cytogenetic response following FLAG/Ida induction and one of seven became bcr-abl negative. All eight patients had a complete cytogenetic response following transplant. Four of five assessable patients became p190 bcr-abl negative after transplant; three of these subsequently relapsed. Both patients with the p210 bcr-abl transcript remained bcr-abl positive in CR after transplant. FLAG/Ida was well tolerated and appears to be effective in inducing remission in relapsed Ph+ ALL. The use of FDR-containing chemotherapy without further conditioning prior to PBSCT deserves further study in heavily pre-treated patients and, in patients with relapsed ALL following BMT, may be a safer option than DLI (donor lymphocyte infusion) by avoiding the associated risk of aplasia. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/9894715/FLAG_idarubicin_and_allogeneic_stem_cell_transplantation_for_Ph_positive_ALL_beyond_first_remission_ L2 - https://doi.org/10.1038/sj.bmt.1701521 DB - PRIME DP - Unbound Medicine ER -