La Tunisie medicale · 2026
Management of Philadelphia chromosome-positive B-acute lymphoblastic leukemia in Tunisia.
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Chaaouri Wiem, Sahbani Hela, Kefi Salma, Achour Meriem, Ayed Wiem, Laamouri Ahlem, Chaker Hend, Fekih Sarra, Ben Lakhal Fatma, Borgi Wejden, Gouider Emna, Menif Samia, Ben Neji Hend, BenLakhal Raihane
Аннотация
INTRODUCTION: The management of Philadelphia-chromosome positive B-cell acute lymphoblastic leukemia (Ph+ B- ALL) is continuously progressing. However, Tunisian data are limited.
AIM: The objective was to describe the clinical and prognostic profile as well as the therapeutic outocomes of Ph+ B- ALL.
METHODS: This was a retrospective and descriptive study conducted in the adult clinical hematology department of Aziza Othmana hospital over a period of 12 years. We included patients aged between 18 and 60 years, diagnosed with de novo or secondary Ph+ B- ALL and treated with a combination of chemotherapy and a tyrosine kinase inhibitor (TKI).
RESULTS: We collected data on 36 patients with initial central nervous system involvement in only one case. The GRAAPH-2005 protocol was the most used regimen (n=29). Thirty-four patients received TKI: imatinib (n=28) and dasatinib (n=6). After induction, all patients achieved cytological remission. Molecular response was assessed in 21 of whom 52% achieved a molecular response. After consolidation, 17 had molecular response evaluation, with 13 achieving a molecular response. Seven patients underwent allogenic hematopoietic stem cell transplantation, and two underwent autologous stem cell transplantation. In terms of disease progression ,14 patients relapsed with a median time to relapse of 18 months [4-42] after TKI initiation. The 5- year overall survival in our series was 25%. The 5-year relapse free survival and event-free survival were 22% respectively.
CONCLUSION: Our study highlighted the various obstacles encountered in the management of Ph+ B-ALL in Tunisia. Addressing these obstacles could improve therapeutic outcomes.
AIM: The objective was to describe the clinical and prognostic profile as well as the therapeutic outocomes of Ph+ B- ALL.
METHODS: This was a retrospective and descriptive study conducted in the adult clinical hematology department of Aziza Othmana hospital over a period of 12 years. We included patients aged between 18 and 60 years, diagnosed with de novo or secondary Ph+ B- ALL and treated with a combination of chemotherapy and a tyrosine kinase inhibitor (TKI).
RESULTS: We collected data on 36 patients with initial central nervous system involvement in only one case. The GRAAPH-2005 protocol was the most used regimen (n=29). Thirty-four patients received TKI: imatinib (n=28) and dasatinib (n=6). After induction, all patients achieved cytological remission. Molecular response was assessed in 21 of whom 52% achieved a molecular response. After consolidation, 17 had molecular response evaluation, with 13 achieving a molecular response. Seven patients underwent allogenic hematopoietic stem cell transplantation, and two underwent autologous stem cell transplantation. In terms of disease progression ,14 patients relapsed with a median time to relapse of 18 months [4-42] after TKI initiation. The 5- year overall survival in our series was 25%. The 5-year relapse free survival and event-free survival were 22% respectively.
CONCLUSION: Our study highlighted the various obstacles encountered in the management of Ph+ B-ALL in Tunisia. Addressing these obstacles could improve therapeutic outcomes.