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Blood, 1 December 2004, Vol. 104, No. 12, pp. 3507-3512.
Prepublished online as a Blood First Edition Paper on August 17, 2004; DOI 10.1182/blood-2004-04-1389.
 Previous Article | Table of Contents | Next Article 
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Combination of intensive chemotherapy and imatinib can rapidly induce high-quality complete remission for a majority of patients with newly diagnosed BCR-ABL–positive acute lymphoblastic leukemia
Masayuki Towatari,
Masamitsu Yanada,
Noriko Usui,
Jin Takeuchi,
Isamu Sugiura,
Makoto Takeuchi,
Fumiharu Yagasaki,
Yasukazu Kawai,
Shuichi Miyawaki,
Shigeki Ohtake,
Itsuro Jinnai,
Keitaro Matsuo,
Tomoki Naoe, and
Ryuzo Ohno, for the Japan Adult Leukemia Study Group
From the Nagoya University Graduate School of Medicine, Nagoya, Japan; Jikei University School of Medicine, Tokyo, Japan; Nihon University School of Medicine, Tokyo, Japan; Toyohashi Municipal Hospital, Toyohashi, Japan; Minami-Okayama Medical Center, Okayama, Japan; Saitama Medical School, Saitama, Japan; Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Saiseikai Maebashi Hospital, Maebashi, Japan; Kanazawa University School of Health Sciences, Kanazawa, Japan; and Aichi Cancer Center, Nagoya, Japan.
The outcome for adult patients with BCR-ABL–positive acute lymphoblastic leukemia (ALL) remains dismal and long-term survival can hardly be achieved except by allogeneic hematopoietic stem cell transplantation (HSCT). The Japan Adult Leukemia Study Group (JALSG) has recently started a phase 2 trial with intensive chemotherapy and imatinib for newly diagnosed BCR-AB–positive ALL patients, and we present here the interim results for the first 24 patients. All patients except one case of early death (96%) attained complete remission (CR) after a single course of remission induction therapy. Polymerase chain reaction (PCR) negativity was achieved in 28% of the patients on day 28, in 50% on day 63, and in up to 78% during the follow-up period. The toxicity profile was almost similar to that with chemotherapy alone. As a result, 15 patients (63%) could receive an allogeneic HSC transplant during their first CR. Although the number of patients is small and the observation period is too short, the combination therapy is very promising and produces high-quality CR for most newly diagnosed patients with BCR-ABL–positive ALL. This is especially useful because it provides the patients with a better chance to receive an allogeneic HSC transplant.
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