Clinical Study on Flumatinib Mesylate Combined with Chemotherapy Followed by Autologous Hematopoietic Cell Transplantation in Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia

Objective To investigate the clinical efficacy and safety of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph⁺ALL) patients treated with second-generation tyrosine kinase inhibitor (TKI) flumatinib mesylate combined with chemotherapy followed by autologous hematopoietic stem cell transplantation(auto-HSCT).

Methods From September 2020 to March 2022, clinical informations of Ph⁺ALL patients who received flumatinib mesylate, chemotherapy and auto-HSCT were collected and analyzed.

Results Of the 8 patients who were enrolled, a median age was 43 years old. The BCR-ABL transcript type was P190 in patients with the exception of one P210. It was determined that 2 patients suffered from tuberculosis (TB), and 1 patient developed central nervous system leukemia (CNSL). All patients got clinical remissions after the chemotherapy. A total of 4 patients (50%) received auto-HSCT in major molecular response (MMR). However, 1 patient (12.5%) relapsed following auto-HSCT and was switched to dasatinib therapy. Flumatinib was used during the induction and consolidation chemotherapy except the period of HSCT. Myelosuppression and infection were the most common side effects. At a median follow-up of 19.22 months, the 1-year OS rate was 75%.

Conclusion Flumatinib combined with chemotherapy followed by auto-HSCT in Ph⁺ALL achieved a great remission rate and safety.