Allogeneic Stem Cell Transplantation for Philadelphia Chromosome-Positive Acute Myeloid Leukemia

Philadelphia chromosome-positive acute myeloid leukemia (Ph+-AML) has a poor response to anthracycline- and cytarabine-containing regimens, high relapse rate, and dismal prognosis. Although therapy with imatinib and allogeneic stem cell transplantation (allo-SCT) is promising, relatively short follow-up limits understanding of long-term results of these therapies. This report describes the outcomes of 3 cases of Ph+-AML diagnosed and transplanted at the University of Nebraska Medical Center between 2004 and 2011. These patients, young and without major comorbidities, received induction therapy with 7 days of cytarabine and 3 days of idarubicin along with imatinib and consolidation therapy with high-dose cytarabine (with or without imatinib). All patients underwent 10/10 HLA-matched peripheral blood allo-SCT (sibling donor for first and third patients and unrelated donor for the second patient; all had acute graft-versus-host disease (GVHD), and the first and third patients had chronic GVHD. All patients are currently alive and experiencing complete remission at 116, 113, and 28 months after diagnosis, respectively. This report shows that the use of allo-SCT with resultant graft-versus-leukemia effect and the addition of imatinib can result in long-term remission and possible cure in some patients with Ph+-AML.

Target Audience

This activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Describe the rationale for the use of imatinib in the treatment of patients with Ph+-AML
  • Identify the evidence supporting clinicopathologic distinction between Ph+-AML and chronic blast phase CML
  • Discuss the role of SCT in the treatment of Ph+-AML
Additional information
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Course summary
Available credit: 
  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician
Course opens: 
07/08/2014
Course expires: 
07/08/2015
Cost:
$0.00
Vijaya Raj Bhatt, MBBS
Department of Internal Medicine, Division of Hematology-Oncology
University of Nebraska Medical Center
Omaha, Nebraska
Bhavana J. Dave, PhD
Human Genetics Laboratory, Munroe Meyer Institute for Genetics and Rehabilitation
University of Nebraska Medical Center
Omaha, Nebraska
Mojtaba Akhtari, MD
Department of Internal Medicine, Division of Hematology-Oncology
University of Nebraska Medical Center
Omaha, Nebraska
Warren G. Sanger, PhD
Human Genetics Laboratory, Munroe Meyer Institute for Genetics and Rehabilitation
University of Nebraska Medical Center
Omaha, Nebraska
R. Gregory Bociek, MD
Department of Internal Medicine, Division of Hematology-Oncology
University of Nebraska Medical Center
Omaha, Nebraska
Anne Kessinger, MD
Department of Internal Medicine, Division of Hematology-Oncology
University of Nebraska Medical Center
Omaha, Nebraska
Jennifer N. Sanmann, PhD
Human Genetics Laboratory, Munroe Meyer Institute for Genetics and Rehabilitation
University of Nebraska Medical Center
Omaha, Nebraska
James O. Armitage, MD
Department of Internal Medicine, Division of Hematology-Oncology
University of Nebraska Medical Center
Omaha, Nebraska
Ji Yuan, MD, PhD
Department of Pathology and Microbiology
University of Nebraska Medical Center
Omaha, Nebraska
 

Available Credit

  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician

Accreditation Period

Course opens: 
07/08/2014
Course expires: 
07/08/2015

Price

Cost:
$0.00
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Required Hardware/software

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  • A device with an Internet connection
  • Adobe Reader or other PDF reader software for article and certificate viewing/printing