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真实世界中伊马替尼在BCR-ABL阳性急性淋巴细胞白血病中的应用

OBJECTIVE: To explore the efficacy and prognostic factors of imatinib (IM) combined with chemotherapy for BCR-ABL gene positive acute lymphoblastic leukemia (ALL). METHODS: A total of 209 BCR-ABL(+)ALL patients treated with imatinib plus chemotherapy from April 2003 to August 2015 were enrolled in t...

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Formato: Online Artículo Texto
Lenguaje:English
Publicado: Editorial office of Chinese Journal of Hematology 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364881/
https://www.ncbi.nlm.nih.gov/pubmed/27801322
http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2016.10.014
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description OBJECTIVE: To explore the efficacy and prognostic factors of imatinib (IM) combined with chemotherapy for BCR-ABL gene positive acute lymphoblastic leukemia (ALL). METHODS: A total of 209 BCR-ABL(+)ALL patients treated with imatinib plus chemotherapy from April 2003 to August 2015 were enrolled in the study, and 106 patients underwent hematopoietic stem cell transplantation (HSCT). RESULTS: The complete remission (CR) rate was 97.9% in newly diagnosed patients. WBC≥100×10(9)/L at diagnosis was a poor factor for overall survival (OS) (P=0.043). Without HSCT, not achieved CR within 4 weeks in the first cycle induction chemotherapy and complete molecular remission (CMR) not achieved during the treatment were adverse factors for OS (P<0.001, P=0.009, P<0.001, respectively), as well as for relapse free survival (RFS) (P<0.001, <0.001 and <0.001, respectively). Of the 106 patients who underwent allo-HSCT or auto-HSCT, there was no statistically significant difference on the OS and RFS. There was no significant difference on OS in patients treated with imatinib or not in the induction chemotherapy, but the former showed higher 5-year RFS rate (37.0% vs 24.0%, P=0.005). The survival of the patients who took tyrosine kinase inhibitors (TKIs) regularly and continuously was the best (40 patients changed to other TKI due to relapse/unsatisfactory decrease in transcription level/occurrence of mutation), followed by those who interrupted TKIs during the bone marrow suppression, those who took TKIs irregularly the worst. The 5-year OS rates among three groups were 46.0%, 28.0% and 17.0%, respectively (P=0.004). The 5-year EFS rates among three groups were 38.0%, 28.0% and 17.0%, respectively (P<0.001). CONCLUSION: TKIs plus chemotherapy followed by HSCT improved the prognosis of the patients with BCR-ABL(+)ALL patients. It is important to administer TKIs regularly and continuously to improve the outcome of BCR-ABL(+)ALL patients.
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spelling pubmed-73648812020-07-16 真实世界中伊马替尼在BCR-ABL阳性急性淋巴细胞白血病中的应用 Zhonghua Xue Ye Xue Za Zhi 论著 OBJECTIVE: To explore the efficacy and prognostic factors of imatinib (IM) combined with chemotherapy for BCR-ABL gene positive acute lymphoblastic leukemia (ALL). METHODS: A total of 209 BCR-ABL(+)ALL patients treated with imatinib plus chemotherapy from April 2003 to August 2015 were enrolled in the study, and 106 patients underwent hematopoietic stem cell transplantation (HSCT). RESULTS: The complete remission (CR) rate was 97.9% in newly diagnosed patients. WBC≥100×10(9)/L at diagnosis was a poor factor for overall survival (OS) (P=0.043). Without HSCT, not achieved CR within 4 weeks in the first cycle induction chemotherapy and complete molecular remission (CMR) not achieved during the treatment were adverse factors for OS (P<0.001, P=0.009, P<0.001, respectively), as well as for relapse free survival (RFS) (P<0.001, <0.001 and <0.001, respectively). Of the 106 patients who underwent allo-HSCT or auto-HSCT, there was no statistically significant difference on the OS and RFS. There was no significant difference on OS in patients treated with imatinib or not in the induction chemotherapy, but the former showed higher 5-year RFS rate (37.0% vs 24.0%, P=0.005). The survival of the patients who took tyrosine kinase inhibitors (TKIs) regularly and continuously was the best (40 patients changed to other TKI due to relapse/unsatisfactory decrease in transcription level/occurrence of mutation), followed by those who interrupted TKIs during the bone marrow suppression, those who took TKIs irregularly the worst. The 5-year OS rates among three groups were 46.0%, 28.0% and 17.0%, respectively (P=0.004). The 5-year EFS rates among three groups were 38.0%, 28.0% and 17.0%, respectively (P<0.001). CONCLUSION: TKIs plus chemotherapy followed by HSCT improved the prognosis of the patients with BCR-ABL(+)ALL patients. It is important to administer TKIs regularly and continuously to improve the outcome of BCR-ABL(+)ALL patients. Editorial office of Chinese Journal of Hematology 2016-10 /pmc/articles/PMC7364881/ /pubmed/27801322 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2016.10.014 Text en 2016年版权归中华医学会所有 http://creativecommons.org/licenses/by-nc-sa/3.0/ This work is licensed under a Creative Commons Attribution 3.0 License (CC-BY-NC). The Copyright own by Publisher. Without authorization, shall not reprint, except this publication article, shall not use this publication format design. Unless otherwise stated, all articles published in this journal do not represent the views of the Chinese Medical Association or the editorial board of this journal.
spellingShingle 论著
真实世界中伊马替尼在BCR-ABL阳性急性淋巴细胞白血病中的应用
title 真实世界中伊马替尼在BCR-ABL阳性急性淋巴细胞白血病中的应用
title_full 真实世界中伊马替尼在BCR-ABL阳性急性淋巴细胞白血病中的应用
title_fullStr 真实世界中伊马替尼在BCR-ABL阳性急性淋巴细胞白血病中的应用
title_full_unstemmed 真实世界中伊马替尼在BCR-ABL阳性急性淋巴细胞白血病中的应用
title_short 真实世界中伊马替尼在BCR-ABL阳性急性淋巴细胞白血病中的应用
title_sort 真实世界中伊马替尼在bcr-abl阳性急性淋巴细胞白血病中的应用
topic 论著
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364881/
https://www.ncbi.nlm.nih.gov/pubmed/27801322
http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2016.10.014
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