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Prepublished online as a Blood First Edition Paper on May 13, 2002; DOI 10.1182/blood-2002-03-0704. This Article Full Text (PDF) All Versions of this Article: 2002-03-0704v1 100/7/2357    most recent Alert me when this article is cited Alert me if a correction is posted 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 Dombret, H. Articles by Fiere, D. Search for Related Content PubMed PubMed Citation Articles by Dombret, H. Articles by Fiere, D. Social Bookmarking                   What's this? Submitted March 6, 2002 Accepted April 22, 2002 Outcome of Treatment in Adults with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia - Results of the Prospective Multicenter LALA-94 Trial Herve Dombret*, Jean Gabert, Jean-Michel Boiron, Francoise Rigal-Huguet, Didier Blaise, Xavier Thomas, Andre Delannoy, Agnes Buzyn, Chrystele Bilhou-Nabera, Jean-Michel Cayuela, Pierre Fenaux, Jean-Henri Bourhis, Nathalie Fegueux, Christiane Charrin, Claude Boucheix, Veronique Lheritier, Helene Esperou, Elizabeth MacIntyre, Jean-Paul Vernant, and Denis Fiere Hematology, Hopital Saint-Louis, Paris, France Biochemistry and Molecular Biology, Hopital Nord, Marseille, France Hematology, Hopital Haut-Leveque, Pessac, France Hematology, Hopital Purpan, Toulouse, France Hematology, Institut Paoli-Calmettes, Marseille, France Hematology, Hopital Edouard Herriot, Lyon, France Hematology, Cliniques Universitaires St Luc, Brussels, Belgium Hematology, Hopital Necker, Paris, France Hematology, Hopital Claude Huriez, Lille, France Hematology, Institut Gustave Roussy, Villejuif, France Hematology, Hopital Lapeyronie, Montpellier, France INSERM U268, Hopital Paul Brousse, Villejuif, France Hematology, Hopital Pitie-Salpetriere, Paris, France * Corresponding author; email: herve.dombret{at}sls.ap-hop-paris.fr. From 1994 to 2000, 154 adults with Ph+ and/or BCR-ABL+ ALL were treated according to a prospective trial (median follow-up, 4.5 years) with the aim to study the prognostic value of early response to therapy and the role of stem cell transplantation (SCT) in first complete remission (CR). All received a standard induction course followed by a course of mitoxantrone and intermediate-dose cytarabine (HAM). After each course, minimal residual disease was tested by specific RT-PCR (median sensitivity, 10-5). Allogeneic SCT (if a donor) or autologous SCT (if not) was planned at 3 months in all patients in CR after HAM. CR rates after induction, after HAM, and at 3 months were 53%, 67%, and 62%, respectively. High leukocyte count and m-bcr subtype were the two identified bad-prognosis factors for CR at 3 months, both superseded by a poor early response assessed at Day 8 of the induction course. HAM-associated salvage rate was higher in patients with M-bcr than in those with m-bcr ALL (55% versus 30%; P=0.05). In the 103 patients eligible for SCT, the existence of a donor and the negative BCR-ABL status after HAM were independently predictive of remission duration (P<0.001 and 0.01, respectively) and survival (P=0.02 and 0.01, respectively). Relapse was the most common cause of treatment failure in all patient groups. Allogeneic SCT in first CR is the current best treatment option in adults with the disease. New strategies must be tested during early phases of therapy to increase the rate of BCR-ABL negative remissions. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: 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. 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