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Jul 23, 2024, 06:05

Talha Badar: The role of allogeneic stem cell transplantation in Ph+ve ALL

Talha Badar shared on X:

“The role of allogeneic stem cell transplantation in Ph+ve ALL?

Outcome of Ph+ve ALL has significantly improved with TKI combinations and not considered high risk disease anymore.

Talha Badar

Not too long ago, chemotherapy combinations with 1st or 2nd generation TKI showed OS benefit of allowing-HCT utilizing time dependent analysis!

Talha Badar

Most recently reported PhALLCON study 57% of pts in ponatinib arm compared to 30% imatinib arm received allo-HCT.

Recently conducted retrospective analysis among pts who achieve CMR at 3 months showed benefit of allo-HCT in improving CIR but not OS.

Talha Badar

‘The role of allogeneic transplant for adult Ph⁺ ALL in CR1 with complete molecular remission: a retrospective analysis‘

Authors: Armin Ghobadi, Michael Slade, Hagop Kantarjian, Julio Alvarenga, Ibrahim Aldoss, Kahee A. Mohammed, Elias Jabbour, Rawan Faramand, Bijal Shah, Frederick Locke, Warren Fingrut, Jae H. Park, Nicholas J. Short, Feng Gao, Geoffrey L. Uy, Peter Westervelt, John F. DiPersio, Richard E. Champlin, Monzr M. Al Malki, Farhad Ravandi, Partow Kebriaei.”

Talha Badar

Our real-world analysis through COMMAND consortium also suggest benefit of alloHCT in improving RFS but not OS in contemporary era.

Talha Badar

Updated results for D-ALBA study showed 27/29 pts who received dasatinib plus blina and achieved CMR remained in remission on long-term fu > 4 yrs

Talha Badar

Conclusion

There is significant international heterogeneity in available treatment; ponatinib, blinatumomab for induction outside of clinical trial are not readily available globally.

Resources restricted countries and several countries in Europe still utilize imatinib and chemo for induction, in those situations allo-HCT consolidation is valid option.

One can possibly avoid allo-HCT if potent TKI and blina consolidation can be give and pts achieves early CMR. allo-HCT should be considered in concurrent HR mutation such as IKZF1+.”

Source: Talha Badar/X

Dr. Talha Badar, MD, is a specialist in Hematology Oncology based in Mayo Clinic, Jacksonville, Florida. His primary areas of expertise include Leukemia, particularly Acute Myeloid Leukemia (AML), Myelodysplastic Syndrome (MDS), Acute Lymphoblastic Leukemia (ALL), and Bone Marrow Transplantation. Over his career, he has actively contributed to clinical research and clinical trials.

Armin Ghobadi Bijal Shah cancer Elias Jabbour Farhad Ravandi Feng Gao Frederick Locke Geoffrey L. Uy Hagop Kantarjian Ibrahim Aldoss Jae H. Park John F. DiPersio Julio Alvarenga Kahee A. Mohammed Michael Slade Monzr M. Al Malki Nicholas J. Short OncoDaily Oncology Partow Kebriaei Peter Westervelt Rawan Faramand Richard E. Champlin Talha Badar Warren Fingrut

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