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The following is a summary of “Post-transplant TKIs for Ph+ ALL: practices to date and clinical significance,” published in the January 2025 issue of Hematology by Nishiwaki et al.
Post-transplant tyrosine kinase inhibitors (TKIs) may help prevent relapse after allogeneic hematopoietic cell transplantation (allo-HCT) for philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL), but their real-world efficacy is unclear.
Researchers conducted a retrospective study on post-transplant TKIs in preventing relapse after allo-HCT for Ph+ALL.
They conducted a study across 7 centers, including 173 patients with Ph+ALL who underwent allo-HCT between 2002 and 2022. Post-transplant TKIs were given to 28% of patients: 7% as prophylaxis during complete molecular remission (CMR) and 21% in response to measurable residual disease (MRD) positivity.
The results showed that the median first post-transplant TKI duration was 13.7 months for the prophylactic group and 4.0 months for the MRD-triggered group. Prophylactic TKIs showed higher 5-year RFS for patients not in CMR at allo-HCT (100% vs 73%; P = 0.11). Significant RFS differences were noted among prophylactic, non-TKI, and MRD-triggered groups. Patients with white blood cell count <15000/µl at diagnosis and no additional chromosomal abnormalities had similar 5-year RFS across TKI strategies (100% vs 85% vs 80%; P = 0.87).
Investigators concluded that MRD-triggered TKI use was effective in selecting low-risk patients and emphasized the potential of tailored TKI strategies based on risk factors.
Source: link.springer.com/article/10.1007/s12185-025-03917-1#Abs1
