Phase II trial of HyperCVAD and Dasatinib in patients with relapsed Philadelphia chromosome positive acute lymphoblastic leukemia or blast phase chronic myeloid leukemia. Issue 3 (March 2014)

• Record Type: Journal Article
• Authors: Benjamini, Ohad; Dumlao, Theresa Liu; Kantarjian, Hagop; O'Brien, Susan; Garcia‐Manero, Guillermo; Faderl, Stefan; Jorgensen, Jeffrey; Luthra, Rajyalakshmi; Garris, Rebecca; Thomas, Deborah; Kebriaei, Partow; Champlin, Richard; Jabbour, Elias; Burger, Jan; Cortes, Jorge; Ravandi, Farhad
• Is Part Of: American journal of hematology. Volume 89:Issue 3(2014:Mar.)
• Page Start: 282
• Page End: 287
• Publication Date: 2014-03
• Subjects: Hematology -- Periodicals; 616.15
• DOI: 10.1002/ajh.23624
• Languages: English
• ISSNs: 0361-8609

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>Dasatinib is a second generation tyrosine kinase inhibitor, with activity in imatinib resistant Ph‐positive ALL. We have treated 34 patients with relapsed Philadelphia chromosome positive acute lymphoblastic leukemia (ALL) (<italic>n</italic> = 19) or lymphoid blast phase of chronic myelogenous leukemia (CML‐LB) (<italic>n</italic> = 15) with the combination of dasatinib and the hyperCVAD regimen. Prior regimens included hyperCVAD plus imatinib (<italic>n</italic> = 11, 4 had transplant in first CR), other combination chemotherapy (<italic>n</italic> = 12), monotherapy with kinase inhibitors other than dasatinib (<italic>n</italic> = 9), and investigational agents (<italic>n</italic> = 2). Pretreatment <italic>ABL</italic> mutations were noted in 10 patients. The overall response rate was 91%, with 24 patients (71%) achieving complete response (CR), and 7(21%) CR with incomplete platelet recovery (CRp). Two patients died during induction and one had progressive disease. Twenty‐six patients (84%) achieved complete cytogenetic remission after one cycle of therapy. Overall, 13 patients (42%) achieved complete molecular response, and 11 patients (35%) had major molecular response (<italic>BCR‐ABL/ABL</italic><0.1%). Nine patients proceeded to allogeneic transplantation. Grades 3 and 4 toxicities included hemorrhage, pleural and pericardial effusions and infections. The median follow‐up for patients with CML‐LB is 37.5 months (range, 7–70 months) with a 3‐year overall survival of 70%; 68% remained in CR at 3 years. For ALL patients, the median follow‐up is 52 months (range, 45–59 months) with a 3‐year survival of 26%; 30% remain in CR at 3 years. The combination of HyperCVAD regimen with dasatinib is effective in patients with relapsed Ph‐positive ALL and CML‐LB. Am. J. Hematol. 89:282–287, 2014. © 2013 Wiley Periodicals, Inc.</p> </abstract>