Randomized study of reduced-intensity chemotherapy combined with imatinib in adults with Ph-positive acute lymphoblastic leukemia by Yves Chalandon, Xavier.

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Randomized study of reduced-intensity chemotherapy combined with imatinib in adults with Ph-positive acute lymphoblastic leukemia by Yves Chalandon, Xavier Thomas, Sandrine Hayette, Jean-Michel Cayuela, Claire Abbal, Françoise Huguet, Emmanuel Raffoux, Thibaut Leguay, Philippe Rousselot, Stéphane Lepretre, Martine Escoffre-Barbe, Sébastien Maury, Céline Berthon, Emmanuelle Tavernier, Jean-François Lambert, Marina Lafage-Pochitaloff, Véronique Lhéritier, Sylvie Chevret, Norbert Ifrah, and Hervé Dombret Blood Volume 125(24):3711-3719 June 11, 2015 ©2015 by American Society of Hematology

Outcome by randomization arm. Outcome by randomization arm. (A) EFS by randomization arm. At 5 years, the EFS rate was estimated at 32.1% (95% CI, 24.0-40.4) in arm B vs 42.2% (95% CI, 33.5-50.6) in arm A (P = .13). (B) OS by randomization arm. At 5 years, the OS rate was estimated at 43.0% (95% CI, 33.9-51.7) in arm B vs 48.3% (95% CI, 39.2-56.8) in arm A (P = .37). Yves Chalandon et al. Blood 2015;125:3711-3719 ©2015 by American Society of Hematology

Post-SCT outcome by stem cell source (allogeneic SCT cohort). Post-SCT outcome by stem cell source (allogeneic SCT cohort). (A) Post-SCT RFS by stem cell source. At 5 years, the posttransplant RFS rate was 57.1% (95% CI, 44.1-68.2) in patients who received SCT from unrelated donors, 41.6% (95% CI, 30.0-52.4) in those who received SCT from sibling donors, and 38.5% (95% CI, 14.0-62.8) in those who received CB-SCT (P = .22). (B) Post-SCT OS by stem cell source. At 5 years, the posttransplant OS rate was 61.7% (95% CI, 48.7-72.3) in patients who received SCT from unrelated donors, 52.3% (95% CI, 40.1-63.2) in those who received SCT from sibling donors, and 53.9% (95% CI, 24.8-76.0) in those who received CB-SCT (P = .52). Yves Chalandon et al. Blood 2015;125:3711-3719 ©2015 by American Society of Hematology

Role of SCT in CR1. Role of SCT in CR1. Simon-Makuch plots for RFS (A) and OS (B) in CR patients. t0 was the time of hematologic CR achievement. RFS and OS were significantly prolonged in the allogeneic SCT cohort (HR, 0.69 [95% CI, 0.49-0.98; P = .036] and 0.64 [95% CI, 0.44-0.93; P = .020], respectively, by the Andersen-Gill test). Simon-Makuch plots for RFS (C) and OS (D) in patients in MMolR at MRD2 time point. t0 was the time of MRD2 MMolR achievement. RFS and OS were similar in the autologous and allogeneic SCT cohorts (HR, 0.94 [95% CI, 0.53-1.65; P = .82] and 0.95 [95% CI, 0.51-1.74; P = .86], respectively, by the Andersen-Gill test). A 3-month RFS landmark period (median time from CR to transplantation) was used, because patients should be alive but also in CR1 to be actually transplanted. This landmark allowed minimizing the bias related to early relapses when comparing OS with this method. Yves Chalandon et al. Blood 2015;125:3711-3719 ©2015 by American Society of Hematology