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Impact of the type of TKI prior to allo-HSCT on outcomes in patients with Ph+ ALL
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A retrospective, registry-based analysis assessed the impact of the type of tyrosine kinase inhibitor (TKI) used prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) on post-transplant outcomes in adult patients with Philadelphia positive (Ph+) acute lymphoblastic leukemia (ALL).1 This analysis included 863 patients with Ph+ ALL who were treated with imatinib (n = 606), dasatinib (n = 163), or both (n = 94).1 Results were published in Transplantation and Cellular Therapy by Giebel et al.1
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At 2 years, no significant difference was observed in the pre-allo-HSCT imatinib, dasatinib, and imatinib + dasatinib treatment groups for:
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While the cumulative incidences of Grade 2–4 graft-versus-host disease (GvHD) and chronic GvHD were similar between treatment groups, dasatinib was associated with a significantly higher risk of Grade 3–4 acute GvHD (20%) compared with imatinib or imatinib + dasatinib (10% vs 13%, respectively; p = 0.002). |
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Multivariable analysis showed that dasatinib was associated with lower GvHD-free and relapse-free survival vs imatinib (hazard ratio, 1.27; 95% confidence interval, 1–1.62; p = 0.048). |
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These findings suggest that the choice of TKI (imatinib or dasatinib) has no impact on survival after allo-HCT in Ph+ ALL; however, pre- allo-HSCT dasatinib may raise the risk of severe acute GvHD.
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- Giebel S, Labopin M, Peric Z, et al. Impact of the type of tyrosine kinase inhibitor (imatinib or dasatinib) used before allo-HCT on outcome of patients with Philadelphia-positive acute lymphoblastic leukemia. A study on behalf of the Acute Leukemia Working Party of the EBMT. Transplant Cell Ther. Online ahead of print. DOI: 10.1016/j.jtct.2024.07.016
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