TY - JOUR T1 - Allogeneic hematopoietic stem cell transplantation for Philadelphia-positive acute lymphoblastic leukemia in children and adolescents: a retrospective multicenter study of the Italian Association of Pediatric Hematology and Oncology (AIEOP). JF - Biol Blood Marrow Transplant Y1 - 2012 A1 - Fagioli, Franca A1 - Zecca, Marco A1 - Rognoni, Carla A1 - Lanino, Edoardo A1 - Balduzzi, Adriana A1 - Berger, Massimo A1 - Messina, Chiara A1 - Favre, Claudio A1 - Rabusin, Marco A1 - Lo Nigro, Luca A1 - Masetti, Riccardo A1 - Prete, Arcangelo A1 - Locatelli, Franco KW - Adolescent KW - Antineoplastic Combined Chemotherapy Protocols KW - Benzamides KW - Child KW - Child, Preschool KW - Disease-Free Survival KW - Drug Administration Schedule KW - Female KW - Fusion Proteins, bcr-abl KW - Graft vs Host Disease KW - Hematopoietic Stem Cell Transplantation KW - Humans KW - Infant KW - Italy KW - Male KW - Philadelphia Chromosome KW - Piperazines KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma KW - Pyrimidines KW - Remission Induction KW - Retrospective Studies KW - Secondary Prevention KW - Transplantation, Homologous KW - Young Adult AB -

Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) still represents a major challenge. We report the experience of the Italian Association of Pediatric Hematology and Oncology (AIEOP) with allogeneic hematopoietic stem cell transplantation (HSCT) in children with Ph+ ALL from 1990 to 2008. Sixty-nine patients received HSCT from either a related (37, 54%) or an unrelated (32, 46%) donor. Twenty-five patients (36%) underwent transplantation before 2000 and 44 (64%) after 2000. Twenty-three patients (33%) received Imatinib mesylate treatment before HSCT and seven (10%) after HSCT. After a median follow-up of 56 months, the overall survival (OS) probability was 51% (95% confidence interval [CI], 38-63), the leukemia-free survival (LFS) was 47% (95% CI, 34-59), transplantation-related mortality (TRM) was 17% (95% CI, 10-30), and relapse incidence (RI) was 36% (95% CI, 26-50). Transplantation in first complete remission, female gender, and lower WBC count at diagnosis were associated with a better LFS in both univariate and multivariate analyses. Patients with p210 transcript had a trend for a worse prognosis compared with those who had the p190 transcript. Our series confirms the role of HSCT in the eradication of Ph+ ALL. Early HSCT is recommended once morphologic remission is obtained.

VL - 18 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22019726?dopt=Abstract ER -