Clinical observation of Gleevec combined with myeloablative allogeneic stem cells transplantation in treatment of chronic myeloid leukemia / 浙江大学学报·医学版

ABSTRACT

<p><b>OBJECTIVE</b>To observe the efficacy of Gleevec combined with myeloablative allogeneic stem cells transplantation(Allo-SCT) for the treatment of chronic myeloid leukemia (CML).</p><p><b>METHODS</b>Nine patients with CML were treated with Gleevec before and after Allo-SCT, with 5 in the chronic phase (CP), 2 in the accelerated phase (AP) and 2 in the blast-crisis phase (BP). The donors were HLA matched identical siblings (n=7) and matched unrelated donors (n=2). The conditioning regimen is BuCy2. Mycophenolate mofetil combined with cyclosporin A and methotrexate was used for the prevention of acute GVHD.</p><p><b>RESULTS</b>All patients achieved completed hemopoietic remission (HCR) treated with pre-transplant Gleevec. The median period to gain absolute neutrophil count>0.5x10(9)/L was 12 d (8 approximately 26 d) and that for platelet count>20x10(9)/L was 20 d (8 approximately 25 d). Three cases suffered from acute GVHD and 4 from chronic GVHD. All patients achieved completed engraftment and completed molecular remission. The rate of disease free survival was 88.9% after a median follow-up of 31 m (range 7 approximately 34 m).</p><p><b>CONCLUSION</b>The treatment of CML consisting of myeloablative Allo-SCT combined with Gleevec before and after transplantation is an effective and safe method for CML.</p>