Lymphoblastic Leukemia, Acute Clinical Trial
Official title:
An Observatory for Patients Aged 55 Years and Over With Philadelphia Chromosome Positive (Ph+ or BCR-ABL+) Acute Lymphoblastic Leukemia (ALL) and Treated With the Combination of Tyrosine Kinase Inhibitors and Low Intensity Chemotherapy.
The use of imatinib in combination with chemotherapy is now considered as the gold standard
for the treatment of Ph+ ALL. The complete remission (CR) rate is 90% versus 20% to 40% with
chemotherapy alone. The combination of imatinib, vincristine and dexamethasone is a well
tolerated regimen in aged patients and is also associated with a high CR rate of 80% to 90%
in patient aged 55 years and over. 2. Dasatinib is indicated as first line therapy in Ph+
ALL. Results from the EWALLPH-01 are supporting the use of dasatinib in combination with
low-intensity chemotherapy. A new EWALL-PH-02 study combining nilotinib in combination with
low-intensity chemotherapy is currently initiated within the EWALL centers.
3. The EWALL-PH-01 trial is now closed after the recruitment of 71 patients. The activation
of the EWALL-PH-02 trial is expected for Q1 2012. Based on the recruitment of the EWALL-PH-01
study it could be anticipated that 50 to 100 patients aged more than 55 years will be
diagnosed during this 6 months period of time. In addition, all the EWALL centers are not
participating to the EWALL-PH-02 study and thus these centers could be offered to treat
patient following the EWALL backbone in addition to imatinib. 4. A minimum data set will be
defined in order to collect the data of the patients treated following the EWALL-PH imatinib
study. The main recommendation is to follow as close as possible the procedures of the
EWALL-PH-01 trial (mutation analysis, MRD follow-up) in order to have a comparable data set.
This imatinib treated cohort of patients would be of particular importance in order to better
define the potential benefit of using one TKI compared to one other. From the end of the
EWALL-PH-01 study recruitment to the initiation of the EWALL-PH-02 study, patients were
treated following the common backbone schedule in combination with imatinib or others TKI.
Patients not included in clinical trials for other reasons were also offered a treatment with
the combination of TKIs and backbone low-intensity chemotherapy. The goal of this observatory
retrospective and prospective is to describe the efficacy and the tolerance of the
combination of tyrosine kinase inhibitors in combination with low intensity chemotherapy
(EWALL backbone) in patients with Ph+ ALL aged 55 years and over.
n/a
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