No clear benefit of preventive cranial radiotherapy in childhood Philadelphia-positive acute lymphoblastic leukemia: a retrospective analysis of the EsPhALL2010 study
2024
Abstract
In summary, our data support the concept that CRT has no major role in the treatment of Ph+ ALL, which is in keeping with the evidence provided by the Ponte di Legno group on non-Ph+ ALL13, although it cannot be excluded that there is a potential benefit for patients with CNS disease at diagnosis. The administration of intrathecals and high dose chemotherapy in replacement for CRT allows to spare patients from neuro- cognitive late effects (particularly severe in younger patients) and second malignancies.14, 15 The omission of CRT may be even more attractive in protocols which adopt dasatinib as TKI and may have additional relevance for patients who need a TBI-conditioning regimen for HCT in second-line treatment.
