The efficacy and safety of low-dose chemotherapy combined with tyrosine kinase inhibitors in the treatment of Philadelphia-chromosomal-positive acute lymphoblastic leukemia
10.3760/cma.j.issn.0253-2727.2022.07.004
- VernacularTitle:低剂量化疗联合酪氨酸激酶抑制剂诱导治疗Ph染色体阳性急性淋巴细胞白血病的疗效和安全性
- Author:
Huan WANG
1
;
Ting ZHAO
;
Lijuan HU
;
Zongru LI
;
Hao JIANG
;
Yazhen QIN
;
Yueyun LAI
;
Hongxia SHI
;
Xiaojun HUANG
;
Qian JIANG
Author Information
1. 北京大学人民医院、北京大学血液病研究所、国家血液系统疾病临床医学研究中心，北京 100044
- Keywords:
Leukemia, lymphoblastic, acute, Philadelphia chromosome positive;
Induction therapy;
Tyrosine kinase inhibitors
- From:
Chinese Journal of Hematology
2022;43(7):550-556
- CountryChina
- Language:Chinese
-
Abstract:
Objective:The study aims to explore the efficacy and safety of low-dose chemotherapy combined with tyrosine kinase inhibitor (TKI) as an induction therapy for Philadelphia-chromosomal-positive acute lymphoblastic leukemia (Ph + ALL) . Methods:The data of the consecutive newly diagnosed patients with Ph + ALL were reviewed. The efficacy and safety of low-dose chemotherapy and conventional-dose chemotherapy combined with TKI were compared. Results:A total of 217 patients with a median age of 38 (10-69) years old were included in this study. 78 patients were in the low-dose chemotherapy group, and 139 patients were in the conventional-dose chemotherapy group. There were no significant differences in the 4-week complete remission (CR) rate (98.7% vs 97.0%, P=0.766) and overall CR rate (100% vs 100%, P=1.000) between the two groups. Multivariate analyses showed that the chemotherapy intensity was not related to the disease-free survival rate and overall survival rate. However, the lower incidence of infection ( P=0.017) , the shorter duration of neutropenia ( P=0.001) and PLT<20 × 10 9/L ( P=0.057) , and the lower red blood cell transfusion volume ( P=0.002) were more common in the low-dose chemotherapy group than in the conventional-dose chemotherapy group. Conclusions:The low-dose chemotherapy is superior to the conventional-dose chemotherapy combined with TKI as induction therapy in Ph + ALL with similar efficacy but is safer.
