Efficacy and prognostic factors of imatinib plus CALLG2008 protocol in adult patients with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia
10.1007/s11684-017-0506-y
- Author:
Lou YINJUN
1
;
Ma YAFANG
;
Li CHENYIN
;
Suo SANSAN
;
Tong HONGYAN
;
Qian WENBIN
;
Mai WENYUAN
;
Meng HAITAO
;
Yu WENJUAN
;
Mao LIPING
;
Wei JUYIN
;
Xu WEILEI
;
Jin JIE
Author Information
1. Institute of Hematology
- Keywords:
Philadelphia chromosome;
acute lymphoblastic leukemia;
imatinib;
CALLG2008
- From:
Frontiers of Medicine
2017;11(2):229-238
- CountryChina
- Language:Chinese
-
Abstract:
A CALLG2008 protocol was developed by the Chinese Acute Lymphoblastic Leukemia Cooperative Group for adult acute lymphoblastic leukemia (ALL).We retrospectively analyzed 153 newly diagnosed adult patients with Philadelphia chromosome (Ph)-positive ALL enrolled into imatinib (400 mg/d) plus CALLG2008 regimen between 2009 and 2015.The median age was 40 years (range,18-68 years),with 81 (52.3％) males.The overall hematologic complete remission (CR) rate was 96.7％ after induction.With a median follow-up of 24.2 months,the estimated 3-year overall survival (OS) and event-free survival (EFS) rates were 49.5％ (95％ confidence interval (CI):38.5％-59.5％) and 49.2％ (95％ CI:38.3％-59.2％),respectively.Fifty-eight (36 with haploidentical donor) patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first CR.Among the patients in CR1 after induction,both the 3-year OS and EFS were significantly better in the allo-HSCT group than in the without allo-HSCT group (73.2％,95％ CI:58.3％-83.5％ vs.22.2％,95％ CI:8.7％-39.6％ and 66.5％,95％ CI:50.7％-78.2％ vs.16.1％,95％ CI:5.1％-32.7％,respectively).Multivariate analysis showed that allo-HSCT and achievement of major molecular response were associated with favorable OS or EFS independently.Interestingly,in the allo-HSCT cohort,the donor type (haploidentical versus matched donors) had no significant impact on EFS or OS.All these results suggested that imatinib plus CALLG2008 was an effective protocol for Ph-positive ALL.Haploidentical donors can also be a reasonable alternative expedient donor pool.
