Bone marrow transplant in Ph+ ALL patients

I. Avivi*, A. H. Goldstone

*Corresponding author for this work

Research output: Contribution to journalShort surveypeer-review

Abstract

Although the outcome for Philadelphia positive (Ph +) acute lymphoblastic leukemia (ALL) with conventional chemotherapy is poor, the outcome after a sibling-matched allogeneic bone marrow transplantation (BMT) seems to be significantly better. The surprising success of allogeneic BMT may be because of disease response to high-dose chemotherapy combined with a graft-versus-leukemia effect. However, less than 30% of patients have a matched related donor available, and some of them will be too old/not fit for conventional BMT. While young patients who do not have a matched related donor should be considered for matched unrelated donor (MUD) transplant, older patients may be treated with autologous stem cell transplantation (ASCT) or rarely considered for a low-intensity MUD transplant. The efficacy of autologous BMT compared with chemotherapy is still debatable, although the new tyrosine kinase inhibitor Imatinib may be used for pretransplant purging/post-transplant therapy, aiming to improve autologous and allogeneic BMT results. The advantage of low-intensity sib/MUD allograft compared with chemotherapy is not proven either and is currently under investigation. However, if shown to be curative, low-intensity allograft may significantly improve the outcome of older Ph + ALL patients, who are not eligible for conventional allograft.

Original languageEnglish
Pages (from-to)623-632
Number of pages10
JournalBone Marrow Transplantation
Volume31
Issue number8
DOIs
StatePublished - Apr 2003
Externally publishedYes

Keywords

  • Allogeneic bone marrow transplantation
  • Autologous
  • Ph+ ALL

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