低剂量化疗联合酪氨酸激酶抑制剂诱导治疗Ph染色体阳性急性淋巴细胞白血病的疗效和安全性

OBJECTIVE: The study aims to explore the efficacy and safety of low-dose chemotherapy combined with tyrosine kinase inhibitor (TKI) as an induction therapy for Philadelphia-chromosomal-positive acute lymphoblastic leukemia (Ph(+) ALL). METHODS: The data of the consecutive newly diagnosed patients with Ph(+) ALL were reviewed. The efficacy and safety of low-dose chemotherapy and conventional-dose chemotherapy combined with TKI were compared. RESULTS: A total of 217 patients with a median age of 38（10–69）years old were included in this study. 78 patients were in the low-dose chemotherapy group, and 139 patients were in the conventional-dose chemotherapy group. There were no significant differences in the 4-week complete remission（CR）rate（98.7％ vs 97.0％, P＝0.766）and overall CR rate（100％ vs 100％, P＝1.000）between the two groups. Multivariate analyses showed that the chemotherapy intensity was not related to the disease-free survival rate and overall survival rate. However, the lower incidence of infection（P＝0.017）, the shorter duration of neutropenia（P＝0.001）and PLT<20×10(9)/L（P＝0.057）, and the lower red blood cell transfusion volume（P＝0.002）were more common in the low-dose chemotherapy group than in the conventional-dose chemotherapy group. CONCLUSION: The low-dose chemotherapy is superior to the conventional-dose chemotherapy combined with TKI as induction therapy in Ph(+) ALL with similar efficacy but is safer.