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学科主题: 临床医学
题名:
Administration of imatinib after allogeneic hematopoietic stem cell transplantation may improve disease-free survival for patients with Philadelphia chromosome-positive acute lymphobla stic leukemia
作者: Chen, Huan; Liu, Kai-yan; Xu, Lan-ping; Liu, Dai-hong; Chen, Yu-hong; Zhao, Xiang-yu; Han, Wei; Zhang, Xiao-hui; Wang, Yu; Zhang, Yuan-yuan; Qin, Ya-zhen; Liu, Yan-rong; Huang, Xiao-jun
关键词: Philadelphia chromosome ; Acute lymphoblastic leukemia ; Allogeneic hematopoietic cell transplantation ; Minimal residual disease ; Imatinib
刊名: JOURNAL OF HEMATOLOGY & ONCOLOGY
发表日期: 2012-06-08
DOI: 10.1186/1756-8722-5-29
卷: 5
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Oncology ; Hematology
研究领域[WOS]: Oncology ; Hematology
关键词[WOS]: POLYMERASE-CHAIN-REACTION ; MARROW TRANSPLANTATION ; COMPLETE REMISSION ; CANCER PROGRAM ; CHEMOTHERAPY ; TRANSCRIPTS ; THERAPY ; RELAPSE ; REDUCTION ; INDUCTION
英文摘要:

Background: Maintenance therapy with imatinib during the post-transplant period has been used for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL); however, its efficacy has not been demonstrated. A study was designed to investigate the safety of imatinib and its efficacy in preventing hematological relapse and improving disease-free survival (DFS) when administered after allogeneic hematopoietic stem cell transplantation (allo-HCT).

Methods: Patients with Ph + ALL that received allo-HCT were enrolled in the study. Real-time quantitative reverse-transcription polymerase chain reaction (qRT-PCR) was used to detect BCR-ABL transcript levels. Imatinib therapy was initiated if patient neutrophil counts were > 1.0 x 10(9)/L and platelet counts were > 50.0 x 10(9)/L, or if they displayed either elevated BCR-ABL transcript levels in two consecutive tests, or a BCR-ABL transcript level >= 10(-2) after initial engraftment. Patients receiving imatinib after relapse were assigned to the non-imatinib group. The imatinib treatment was scheduled for 3-12 months, until BCR-ABL transcript levels were negative at least for three consecutive tests or complete molecular remission was sustained for at least 3 months.

Results: A total of 82 patients were enrolled. Sixty-two patients initiated imatinib therapy post-HCT. Imatinib therapy was initiated at a median time of 70 days post-HCT. Grade 3-4 adverse events (AEs) occurred in 17.7% of patients. Ten patients (16.1%) terminated imatinib therapy owing to AEs. Among the patients in imatinib and non-imatinib groups, the estimated 5-year relapse rate was 10.2% and 33.1% (p = 0.016), and the 5-year probability of DFS was 81.5% and 33.5% (p = 0.000) with the median follow-up of 31 months (range, 2.5-76 months) and 24.5 months (range, 4-72 months), respectively. Multivariate analysis identified imatinib maintenance therapy post-HCT as an independent prognostic factor for DFS (p = 0.000, hazard ratio [HR] = 4.8) and OS (p = 0.000, HR = 6.2).

Conclusions: These results indicate that relapse rate can be reduced and DFS may be improved in Ph + ALL patients with imatinib maintenance therapy after HCT. BCR-ABLmonitoring by qRT-PCR can guide maintenance therapy with imatinib including initiation time and treatment duration after allo-HCT.

语种: 英语
所属项目编号: 30971292 ; 2011AA020105
项目资助者: National Natural Science Foundation of China ; National High-tech R&amp ; D Program of China ; Ministry of Health of China
WOS记录号: WOS:000307009600001
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/53663
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

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作者单位: Peking Univ, Peoples Hosp, Inst Hematol, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing 100044, Peoples R China

Recommended Citation:
Chen, Huan,Liu, Kai-yan,Xu, Lan-ping,et al. Administration of imatinib after allogeneic hematopoietic stem cell transplantation may improve disease-free survival for patients with Philadelphia chromosome-positive acute lymphobla stic leukemia[J]. JOURNAL OF HEMATOLOGY & ONCOLOGY,2012,5.
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