Frontiers in Oncology (Jun 2020)

Long-Term Remission Achieved by Ponatinib and Donor Lymphocytes Infusion in a Ph+ Acute Lymphoblastic Leukemia Patient in Molecular Relapse After Allogenic Stem Cell Transplant and Dasatinib: A Case Report

  • Cirino Botta,
  • Cirino Botta,
  • Nadia Caruso,
  • Sabrina Bossio,
  • Francesca Storino,
  • Giuseppe Console,
  • Massimo Martino,
  • Francesco Mendicino,
  • Eugenio Lucia,
  • Rosellina Morelli,
  • Pierpaolo Correale,
  • Fortunato Morabito,
  • Fortunato Morabito,
  • Massimo Gentile,
  • Massimo Gentile,
  • Ernesto Vigna,
  • Ernesto Vigna

DOI
https://doi.org/10.3389/fonc.2020.00967
Journal volume & issue
Vol. 10

Abstract

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Currently, the prognosis of Ph+ acute lymphoblastic leukemia (Ph+ ALL) patients relapsing after an allogenic hematopoietic stem cell transplantation (allo-SCT) remains poor, with few therapeutic options available. Here we present the case of a 32 years old patient with dasatinib-resistant post-transplant molecular relapse of ALL, who received, as second-line therapy, the combination of ponatinib and donor lymphocyte infusion (DLI). The therapy was safe and the patient achieved a sustained minimal residual disease negative disease, still ongoing after 22 months, which was accompanied by several changes in the immune populations distribution within the bone marrow (i.e., the increase in the CD8/CD4 lymphocytes ratio). Our report provides evidence of the efficacy of the third generation TKI inhibitor ponatinib in combination with DLI as second line therapy for Ph+ ALL relapsing after an allo-SCT.

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