{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T02:45:26Z","timestamp":1771296326522,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007313","name":"University of Texas MD Anderson Cancer Center","doi-asserted-by":"publisher","award":["CA016672"],"award-info":[{"award-number":["CA016672"]}],"id":[{"id":"10.13039\/100007313","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Dasatinib monotherapy has demonstrated modest clinical activity in chronic myeloid leukemia in lymphoid blastic phase (CML\u2010LBP). The outcome of Philadelphia chromosome (Ph)\u2013positive acute lymphoblastic leukemia (ALL) has dramatically improved with hyperfractionated cyclophosphamide, vincristine sulfate, doxorubicin hydrochloride, and dexamethasone (hyper\u2010CVAD) in combination with tyrosine kinase inhibitors (TKIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors reviewed 85 patients (23 with CML\u2010LBP and 62 with newly diagnosed Ph\u2010positive ALL) who received hyper\u2010CVAD plus dasatinib.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In the CML\u2010LBP cohort, 19 had prior chronic myeloid leukemia as chronic phase (n = 17; 74%), accelerated phase (n = 1; 4%), or myeloid blastic phase (n = 1; 4%); 4 (17%) presented with de novo CML\u2010LBP. The BCR\u2010ABL1 transcript was p210 in 22 patients (96%) and p190 in 1 patient (4%). In the Ph\u2010positive ALL cohort, p210 and p190 transcripts were detected in 13 patients (21%) and 48 patients (77%), respectively. Patients with CML\u2010LBP were less likely to achieve deep molecular remission than patients with Ph\u2010positive ALL: the major molecular response (MMR) rates were 70% and 95%, respectively (<jats:italic>P<\/jats:italic> = .007), and the complete molecular response (CMR) rates were 55% and 74%, respectively (<jats:italic>P<\/jats:italic> = .16). Survival outcomes were similar for CML\u2010LBP and Ph\u2010positive ALL: the 5\u2010year overall survival (OS) rates were 59% and 48%, respectively (<jats:italic>P<\/jats:italic> = .97). Allogeneic stem cell transplantation was associated with a better outcome in CML\u2010LBP (5\u2010year OS rate, 88% vs 57%; <jats:italic>P<\/jats:italic> = .04). In Ph\u2010positive ALL, the outcome was driven by deeper molecular remission: the 5\u2010year OS rates were 63% and 25% with CMR and MMR, respectively (<jats:italic>P<\/jats:italic> = .002).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The outcome of CML\u2010LBP has improved with hyper\u2010CVAD plus dasatinib therapy with survival comparable to that of Ph\u2010positive ALL. Further improvement may be achieved with the use of novel TKIs and targeted agents.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33539","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T15:47:01Z","timestamp":1617724021000},"page":"2641-2647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Outcome of patients with chronic myeloid leukemia in lymphoid blastic phase and Philadelphia chromosome\u2013positive acute lymphoblastic leukemia treated with hyper\u2010CVAD and dasatinib"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0407-1565","authenticated-orcid":false,"given":"Kiyomi","family":"Morita","sequence":"first","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston 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Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Konopleva","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2983-2738","authenticated-orcid":false,"given":"Nicholas J.","family":"Short","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9003-0390","authenticated-orcid":false,"given":"Courtney D.","family":"DiNardo","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9892-9832","authenticated-orcid":false,"given":"Tapan M.","family":"Kadia","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3631-2482","authenticated-orcid":false,"given":"Guillermo","family":"Garcia\u2010Manero","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7103-373X","authenticated-orcid":false,"given":"Naval","family":"Daver","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4533-5176","authenticated-orcid":false,"given":"Guillermo","family":"Montalban Bravo","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge E.","family":"Cortes","sequence":"additional","affiliation":[{"name":"Department of Medicine Medical College of Georgia Augusta Georgia"},{"name":"Georgia Cancer Center Augusta 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