Treatments of Ph-like acute lymphoblastic leukemia: a real-world retrospective analysis from a single large center in China

Abstract

Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) is a high-risk subtype of ALL. We retrospectively studied 70 cases with Ph-like ALL and here present the largest study of CAR-T cell treatment and haplo-HSCT for this leukemia. Median age was 26 years and median leukocyte count was 31.44 × 10⁹/L. The proportion of patients receiving chemotherapy, KIs, CAR-T cells, and allo-HSCT was 19%, 30%, 46%, and 61%, respectively. The overall response rate was 62%, 73%, and 100% after one month of KI treatment combined with chemotherapy, CAR-T cell therapy, and allo-HSCT, respectively. Five-year DFS and OS were 35% and 51%, respectively. The five-year cumulative incidence of relapse and non-relapse mortality was 63% and 11%, respectively. Allo-HSCT was associated with a better DFS (p = 0.010) and OS (p = 0.000) by univariate analysis. In conclusion, allo-HSCT after KIs together with chemotherapy or CAR-T cell therapy is a safe and feasible treatment modality for Ph-like ALL.

Keywords:

• Philadelphia chromosome-like
• acute lymphoblastic leukemia
• targeted kinase inhibitors
• chimeric antigen receptor (CAR)-T cell therapy
• allogeneic hematopoietic stem cell transplantation

Acknowledgements

The authors thank all members of the study team, the patients and their families.

Author contributions

Hui-ying Qiu and Su-ning Chen designed and supervised the study. Guo-fa Xu, Li-min Liu and Man Wang analyzed the data, wrote the manuscript and prepared the figures. Zhi-bo Zhang and Jun-dan Xie performed experiments and measurements on the samples.

Disclosure statement

The authors declare that they have no competing interests.

Additional information

Funding

This work was supported by Jiangsu Provincial Key RESEARCH and Development Program (Social Development), No. BE2018652. Fuling District Science and Technology Project of Chongqing [FLKJ, 2021ABB1025].