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Salvage and bridging to allogeneic hematopoietic cell transplantation with ponatinib in patients with relapsed or refractory Philadelphia chromosome-positive leukemia

  • Takayoshi Tachibana
  • Satoshi Koyama
  • Taiki Andou
  • Yasufumi Ishiyama
  • Masatsugu Tanaka
  • Hideaki Nakajima
  • Heiwa Kanamori
Original Article
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Abstract

A single-center retrospective study was performed with consecutive patients who received salvage therapy using ponatinib for the aim of allogeneic hematopoietic cell transplantation (HCT) for relapsed or refractory Ph-leukemia between January 2017 and July 2018. A total of ten patients—seven with Ph-acute lymphoblastic leukemia (ALL) and three with chronic phase (CP)/accelerated phase chronic myeloid leukemia (CML)—were eligible. Eight patients had a history of a single tyrosine kinase inhibitor (TKI) use prior to ponatinib. Any mutation of the tyrosine kinase domain was detected in eight patients, including seven of T315I. The median dose of ponatinib was 15 mg with a median duration of 7 weeks (range 4–23 weeks). The median duration from the start of ponatinib to HCT was 54 days (range 35–175 days). Hematological remission was obtained in five Ph-ALL patients. Maintenance therapy of ponatinib was applied to five patients. No vascular occlusion event has occurred over this series of treatments. Salvage therapy with low-dose ponatinib appears to be safe and effective in patients with relapsed or refractory Ph-leukemia, which may immediately bridge to HCT.

Keywords

Ponatinib Philadelphia-positive leukemia Transplantation Bridging therapy 
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Notes

Compliance with ethical standards

Conflict of interest

There are no conflicts of interest to declare.

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Copyright information

© Japanese Society of Hematology 2018

Authors and Affiliations

  1. 1.Department of HematologyKanagawa Cancer CenterYokohamaJapan
  2. 2.Department of Hematology and Clinical Immunology, School of MedicineYokohama City UniversityYokohamaJapan

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