Imatinib combined with modified hyper-CVAD/MA followed by allogeneic hematopoietic stem cell transplantation in CR1 as the front-line therapy for adult Ph(+) acute lymphoblastic leukemia / 中华血液学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the efficacy of imatinib (IM)-based chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-SCT) in first complete remission (CR1) for adult Ph(+) acute lymphoblastic leukemia \[Ph(+)-ALL\].</p><p><b>METHODS</b>From March 2006 to December 2010, 16 adult Ph(+)-ALL were enrolled in the study. All patients received IM combined with standard VDCP ± L as induction therapy then intensive consolidation with modified Hyper-CVAD/MA regimen plus IM, and followed by allo-SCT in CR1. Some of them received IM maintenance therapy after allo-SCT. With the follow up to March 31, 2011, the clinical parameters. overall survival (OS), disease free survival (DFS), relapse incidence (RI), non-relapse mortality (NRM) and prognostic factors were analyzed.</p><p><b>RESULTS</b>All 16 patients achieved morphological complete remission (CR), and 10 of them achieved molecular CR. After transplantation, all patients obtained successful engraftments. With a median follow-up of 27.1 (7.4 - 65.8) months, 14 patients were alive, 2 died from NRM, and 2 relapsed. The estimated OS and DFS at 3 year were (85.9 ± 9.3)% and (83.9 ± 10.5)%, and cumulative RI and NRM at 3 year were (16.1 ± 10.5)% and (14.1 ± 9.3)%, respectively. None prognostic factor was found on analysis.</p><p><b>CONCLUSION</b>IM combined with intensive chemotherapy significantly increased the CR rate and improved the quality of CR, which prepared the feasibility of allo-SCT in CR1. IM therapy pre- and post-allo-SCT would be a promising strategy for adult Ph(+)-ALL to decrease relapse and facilitates favorable OS and DFS.</p>