Efficacy analysis of imatinib combined with chemotherapy for treatment of adults with Philadelphia chromosome-positive acute lymphoblastic leukemia / 白血病·淋巴瘤

ABSTRACT

Objective To investigate the clinical effects of imatinib combined with chemotherapy in adults with Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL). Methods A total of 35 newly diagnosed Ph+ ALL patients from June 2012 to January 2016 in the First Hospital of China Medical University were enrolled. The patients were divided into 21 cases (combined chemotherapy group) and 14 cases (chemotherapy alone group). There were 4 patients in combined chemotherapy group who underwent hematopoietic stem cell transplantation (HSCT) after the first complete remission (CR). The parameters including blood routine, bone marrow morphology, immunoassay, chromosome and fusion genes were detected regularly for efficacy assessment. Results CR rate after the first induction therapy was 76％ (16/21) in combined chemotherapy group and 36％ (5/14) in the chemotherapy alone group, and there was a significant difference of both groups (χ 2 = 5.734, P = 0.033). The median overall survival (OS) time for patients in combined chemotherapy group and chemotherapy alone group were 14 months (2-18 months) and 5 months (0.33-10 months) respectively (U = 12.0, P = 0.007). And the median disease-free survival (DFS) time were 8 months (0-15 months) and 2 months (0-6 months), respectively (U = 12.5, P = 0.007). The median OS and DFS time for transplant patients were 26 months (22-39 months) and 22 months (17-36 months) respectively. Conclusions Imatinib combined chemotherapy can increase CR rate, DFS and OS time for Ph+ ALL patients during the induction therapy, which can gain more chance to receive HSCT. The patients who could receive HSCT as soon as possible after CR1 could get longer survival time.