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Blood, 15 July 2005, Vol. 106, No. 2, pp. 458-463. Prepublished online as a Blood First Edition Paper on April 7, 2005; DOI 10.1182/blood-2004-05-1746. This Article Full Text Full Text (PDF) Supplemental Tables All Versions of this Article: 2004-05-1746v1 106/2/458    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wassmann, B. Articles by Ottmann, O. G. Search for Related Content PubMed PubMed Citation Articles by Wassmann, B. Articles by Ottmann, O. G. Related Collections Neoplasia Oncogenes and Tumor Suppressors Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Early molecular response to posttransplantation imatinib determines outcome in MRD+ Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) Barbara Wassmann, Heike Pfeifer, Michael Stadler, Martin Bornhaüser, Gesine Bug, Urban J. Scheuring, Patrick Brück, Matthias Stelljes, Rainer Schwerdtfeger, Nadezda Basara, Jolanta Perz, Donald Bunjes, Georg Ledderose, Rolf Mahlberg, Anja Binckebanck, Harald Gschaidmeier, Dieter Hoelzer, and Oliver G. Ottmann From the Departments of Hematology/Oncology of the University Hospitals Frankfurt, Hannover, Dresden, Münster, Ulm, Heidelberg, Munich; the Deutsche Klinik für Diagnostik, Wiesbaden; the Klinik für Knochenmarktransplantation, Idar-Oberstein; Krankenanstalt Mutterhaus der Borromäerinnen, Trier; and Novartis Pharma AG, Nürnberg, Germany. In adult Philadelphia chromosome–positive acute lymphoblastic leukemia (Ph+ ALL), minimal residual disease (MRD) after stem cell transplantation (SCT) is associated with a relapse probability exceeding 90%. Starting imatinib in the setting of MRD may decrease this high relapse rate. In this prospective multicenter study, 27 Ph+ ALL patients received imatinib upon detection of MRD after SCT. Bcr-abl transcripts became undetectable in 14 (52%) of 27 patients, after a median of 1.5 months (0.9-3.7 months) (earlyCRmol). All patients who achieved an earlyCRmol remained in remission for the duration of imatinib treatment; 3 patients relapsed after imatinib was discontinued. Failure to achieve polymerase chain reaction (PCR) negativity shortly after starting imatinib predicted relapse, which occurred in 12 (92%) of 13 patients after a median of 3 months. Disease-free survival (DFS) in earlyCRmol patients is 91% ± 9% and 54% ± 21% after 12 and 24 months, respectively, compared with 8% ± 7% after 12 months in patients remaining MRD+ (P < .001). In conclusion, approximately half of patients with Ph+ ALL receiving imatinib for MRD positivity after SCT experience prolonged DFS, which can be anticipated by the rapid achievement of a molecular complete remission (CR). Continued detection of bcr-abl transcripts after 2 to 3 months on imatinib identifies patients who will ultimately experience relapse and in whom additional or alternative antileukemic treatment should be initiated. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. Metzelder, Y. Wang, E. Wollmer, M. Wanzel, S. Teichler, A. Chaturvedi, M. Eilers, E. Enghofer, A. Neubauer, and A. Burchert Compassionate use of sorafenib in FLT3-ITD-positive acute myeloid leukemia: sustained regression before and after allogeneic stem cell transplantation Blood, June 25, 2009; 113(26): 6567 - 6571. [Abstract] [Full Text] [PDF] A. K. Fielding, J. M. Rowe, S. M. Richards, G. Buck, A. V. Moorman, I. J. Durrant, D. I. Marks, A. K. McMillan, M. R. Litzow, H. M. Lazarus, et al. Prospective outcome data on 267 unselected adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia confirms superiority of allogeneic transplantation over chemotherapy in the pre-imatinib era: results from the International ALL Trial MRC UKALLXII/ECOG2993 Blood, May 7, 2009; 113(19): 4489 - 4496. [Abstract] [Full Text] [PDF] D. 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