Efficacy comparison between Ph+ ALL patients treated with chemotherapyplus tyrosine kinase inhibitors followed by allo-HSCT and Ph-ALL patients with allo-HSCT : a case control study from a single center

作者：胡健; 王莉红; 李渊; 邱志祥; 许蔚林; 孙玉华; 尹玥; 刘微; 欧晋平

来源：中华血液学杂志, 2015, 36(7).

DOI：10.3760/cma.j.issn.0253-2727.2015.07.014

• Ph chromosome
• Leukemia,lymphoblastic,acute
• Tyrosine kinase inhibitor
• Hematopoietic stem cell transplantation,allogeneic
• Case control study

Objective To compare the efficacy of the Ph+ acute lymphoblastic leukemia (ALL) patients treated with combination of tyrosine kinase inhibitors (TKI) and chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) and Ph-ALL patients with allo-HSCT.Methods A total of 19 Ph+ALL patients were matched with 19 Ph-ALL patients from 55 B-ALL patients receiving allo-HSCT in our hospital between January 2003 and August 2014 and were analyzed retrospectively.Results Gender,median age,number of patients with blood white count more than 30 × 109/L,number of patients with meningeal leukemia,disease status before allo-HSCT,period of allo-HSCT,the source of stem cell from donors,HLA disparities between donor and recipient,conditioning regimens and number of infused mononuclear cells and CD34+ cells were comparable between two groups of Ph+ and 19 Ph-ALL patients.The median time of engraftment of neutrophil cells was 12 days versus 13 days (P=0.284) and that of platelet 14 days versus 17 days (P=0.246),which were comparable between two groups.The estimated 3-year overall survival (OS) in Ph+ and Ph-ALL groups was (67.5±12.4)％ versus (74.3±11.4)％ (P=0.434) and 3-year disease free survival (DFS) was (67.8±12.4)％ versus (74.3±11.4)％ (P=0.456),respectively.The cumulative incidence of degree 1-Ⅳ acute graft-versus-host disease (aGVHD) in Ph+ and Ph-ALL group was (15.8±8.4)％ versus (21.1±9.4)％ (P=0.665) and that of degree Ⅲ-Ⅳ aGVHD was (5.6 ± 5.4) ％ versus (11.5 ± 7.6) ％ (P=0.541),respectively.The cumulative incidence of cGVHD was (44.1J±14.0) ％ in Ph+ALL group versus (44.1 ± 13.0) ％ in Ph-ALL group (P=0.835) and that of extensive cGVHD was (13.1 ±8.7)％ versus (6.2J±6.1)％ (P=0.379),respectively.The cumulative relapse rate and the cumulative non-relapse rate in both group also have no statistical difference [(10.8±7.2)％ versus (20.0±10.7)％ (P=0.957) and (23.9±12.4)％ versus (7.1±6.9)％(P=0.224),respectively].Conclusion The efficacy of Ph+ALL treated with combination of chemotherapy and TKIs and followed by allo-HSCT is comparable to that of Ph-ALL with allo-HSCT.

• 单位
  北京大学