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Giving children with Philadelphia-positive leukaemia the pill imatinib continuously from the second week of treatment allowed fewer of them to need a transplant, with survival similar to the earlier study that used short courses, but at the cost of more serious toxicity during intensive treatment blocks.
Prospective, intergroup, open-label, single-arm trial across 11 study groups in Europe, Chile and Hong Kong: 155 patients aged 1 to 17 with Philadelphia chromosome-positive acute lymphoblastic leukaemia received imatinib 300 mg/m2 from day 15 of induction continuously through chemotherapy, with transplant reserved for poor early responders (38 percent were transplanted in first remission).
Five-year event-free survival was 57.0 percent and overall survival 71.8 percent, similar to EsPhALL2004 despite fewer transplants. 154 serious adverse events occurred in 80 patients, mostly infections during high-risk blocks and delayed intensifications, including 14 fatal events.
Continuous imatinib from induction lets many children with Philadelphia-positive ALL avoid transplant, but the intensive BFM backbone is toxic; later trials reduced chemotherapy intensity under tyrosine kinase inhibitor cover.
Shares EsPhALL (EsPhALL2004 and EsPhALL2010), Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib.
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib.
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib.
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib, Acute lymphoblastic leukaemia.
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib, Acute lymphoblastic leukaemia.
Shares Imatinib, Acute lymphoblastic leukaemia.
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Imatinib, Acute lymphoblastic leukaemia.
Shares Philadelphia chromosome-positive acute lymphoblastic leukaemia in children (Ph-positive ALL), Acute lymphoblastic leukaemia.