Molecular response and prognostic factors of patients with Philadelphia chromosome/BCR-ABL-positive acute lymphoblastic leukemia treated by imatinib with chemotherapy / 中华血液学杂志
Chinese Journal of Hematology
;
(12): 120-125, 2014.
Artículo
en Chino
| WPRIM
| ID: wpr-295696
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the molecular response and prognostic factors of patients with Philadelphia chromosome/BCR-ABL-positive acute lymphoblastic leukaemia (Ph⁺ ALL) treated by imatinib with chemotherapy.</p><p><b>METHODS</b>From May 2006 to July 2012, 82 adult Ph⁺ ALL patients were enrolled in the study. Forty-eight patients combined imatinib in, and 34 patients after induction therapy. Forty-nine patients underwent allogeneic hematopoietic stem cell transplant (allo-HSCT) after 3 to 5 cycles of consolidation therapy. The molecular response of BCR-ABL mRNA was evaluated by real-time quantitative PCR in every chemotherapy course ending.</p><p><b>RESULTS</b>The complete remission (CR) rate after the first cycle of induction chemotherapy was 76.8% (63/82), with overall CR rate of 92.7% (76/82). The CR rate in the patients combined imatinib in was higher than of those combined imatinib after the first cycle of induction chemotherapy (93.8% vs 52.9%, P<0.001). 55.3% patients BCR-ABL decreased >1 log after induction therapy. Among 76 CR patients, cumulative incidence of relapse was 27.6%, the probabilities of disease-free survival (DFS) and overall survival (OS) at 3 years were 60.5% and 70.2%, respectively. allo-HSCT was an independent favorable factor for decrease of leukemia relapse (P<0.001). allo-HSCT, imatinib combined in the first cycle of induction therapy and female were independent favorable factors for DFS (P<0.01, 0.05 and 0.01, respectively), BCR-ABL mRNA reduction at least 1 log from baseline after the first induction therapy and allo-HSCT were independent favorable factors for OS (P=0.011 and 0.027, respectively).</p><p><b>CONCLUSION</b>Imatinib combined in the first cycle of induction therapy, BCR-ABL mRNA reduction at least 1 log from baseline after the first induction therapy and allo-HSCT improved outcomes of Ph⁺ ALL patients.</p>
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Piperazinas
/
Pronóstico
/
Pirimidinas
/
Terapéutica
/
Trasplante Homólogo
/
Benzamidas
/
Cromosoma Filadelfia
/
Protocolos de Quimioterapia Combinada Antineoplásica
/
Proteínas de Fusión bcr-abl
/
Resultado del Tratamiento
Tipo de estudio:
Estudio diagnóstico
/
Estudio pronóstico
Límite:
Adolescente
/
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
Idioma:
Chino
Revista:
Chinese Journal of Hematology
Año:
2014
Tipo del documento:
Artículo
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