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Imatinib vs dasatinib maintenance therapy post-transplant in patients with Ph+ ALL
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Maintenance therapy with tyrosine kinase inhibitors (TKIs) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with Philadelphia-positive (Ph+) acute lymphoblastic leukemia (ALL) can prevent relapse and improve outcomes; however, a consensus on the optimal TKI maintenance therapy has not been reached.1 Results from a multicenter retrospective analysis of maintenance therapy with two TKIs, imatinib and dasatinib were published in Cancer by Guan et al.1
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| Key learnings |
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Comparison between imatinib (n = 91) and dasatinib (n = 50) cohorts showed no significant difference in the 5-year probabilities of cumulative incidence of relapse (16.1% vs 12.5%), non-relapse mortality (5.2% vs 9.8%), leukemia-free survival (78.8% vs 77.6%), and overall survival (86.5% vs 77.6%), suggesting survival outcomes for patients receiving both TKI maintenance therapies are similar. |
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Imatinib was associated with a lower incidence of mild chronic graft-versus-host disease (5-year rate, 14.9% vs 37.3%; p = 0.03) and gastrointestinal bleeding (2.3% vs. 25.5%; p <0.001) compared with dasatinib . |
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Although both TKIs are viable options for post-transplant prophylaxis, the choice between imatinib and dasatinib should consider individual patient risk profiles and tolerance to potential adverse events, which can impact long-term outcomes and quality of life. |
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These findings highlight that the long-term outcomes of patients with Ph+ ALL undergoing allo-HSCT who received maintenance therapy with imatinib were similar to those who received dasatinib. |
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