伊马替尼联合化疗治疗成人费城染色体阳性急性淋巴细胞白血病46例临床分析

目的探讨伊马替尼联合化疗治疗费城染色体阳性(Ph+)急性淋巴细胞白血病(ALL)的疗效。方法 Ph+ALL患者46例,分别应用VDCP、VDCLP方案联合伊马替尼诱导治疗,完全缓解(CR)后继续伊马替尼联合化疗进行巩固及强化治疗,有合适供者的患者行异基因造血干细胞移植。结果 46例Ph+ALL CR率为67.4%(31/46),无治疗相关死亡。16例患者CR后行造血干细胞移植,10例目前仍无病生存;3例复发;3例死于慢性移植物抗宿主病(GVHD)合并感染。CR后持续巩固及强化治疗的15例患者中位缓解期为13(9～19)个月。结论伊马替尼联合化疗治疗Ph+ALL,CR率较常规化疗诱导治疗明显提高。伊马替尼联合化疗进行巩固治疗,中位缓解时间及生存时间较长,较单用化疗明显延长。

Clinical analysis on Imatinib in combination with chemotherapy for Philadelphia chromosome-positive acute lymphoblastic leukemia

Objective To investigate the efficacy of Imatinib in combination with chemotherapy in treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia(Ph+ALL).Methods Patients with de novo Ph+ALL were administered with induction therapy with VDCP or VDCLP in combination with Imatinib.Subsequently,consolidation and maintenance therapy were started with Imatinib and chemotherapy after complete remission(CR).Patients with suitable donors received allo-hematopoietic stem cell transplantation(HSCT).Results Of the 46 patients,31 achieved CR,with an overall CR rate of 67.4%.There was no death during the therapy.Of the 16 patients who underwent allo-HSCT after CR by Imatinib-based treatment,10 were disease-free survivals,3 relapsed,and 3 died from chronic GVHD complicated with infection.Estimated median remission duration of the 15 CR patients without suitable donors was 13(9-19) months.Conclusion In patients with Ph+ALL given imatinib in combinaion with chemotherapy,CR rate is a significantly higher than in those given conventional chemotherapy.In consolidation therapy with chemotherapy and Imatinib,median remission duration and survival duration are improved compared with conventional chemotherapy.