Effect of TKI Maintenance Therapy After Allogeneic Hematopoietic Stem Cell Transplantation on Recurrence of...

To analyze the impact of tyrosine kinase inhibitor (TKI) maintenance therapy following allogeneic hematopoietic stem cell transplantation (HSCT) in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL) on recurrence rates and prognosis for the 2 transcripts, p190 and p210.

We conducted a retrospective analysis of clinical data from 58 patients diagnosed with Ph + ALL who underwent HSCT. All patients received TKI maintenance therapy following hematopoietic reconstruction post-transplantation. We compared the clinical characteristics and prognostic differences between 2 transcript types: p190 (n = 43) and p210 (n = 15).

In terms of clinical characteristics, no significant differences were observed between patients with the 2 transcripts. Multivariate analysis revealed that the T3151 mutation (HR = 5.021, 95% CI [1.129-22.3], P = .034) was an independent risk factor for relapse-free survival (RFS) post-transplantation. Additionally, TKI maintenance therapy for over 1 year was identified as a protective factor for RFS (HR = 0.315, 95% CI [0.115-0.86], P = .025). The median RFS was 89.4 months for the p190 group compared to 59.1 months for the p210 group, which was statistically significant (P = .031). In the subgroup with more than 1 year of TKI maintenance therapy, the median RFS times for p190 and p210 were 95.3 and 90.5 months, respectively, with no statistically significant difference in RFS (P = .080).

The p190 group demonstrated longer RFS compared to the p210 group. However, with early HSCT following induction remission and long-term TKI maintenance therapy post-transplant, the poor prognosis associated with p210 could be mitigated, leading to a trend towards equivalence in outcomes between the 2 transcripts.