Prognostic significance of Ph-positive acute lymphoblastic leukemia.
- Author:
Li ZHOU
1
;
Jiong HU
1
;
Juan CHEN
1
;
Shenghong DU
1
;
Aihua WANG
1
;
Jianhua YOU
1
;
Wen WU
1
;
Zhixiang SHEN
1
;
Junmin LI
1
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Benzamides; therapeutic use; Disease-Free Survival; Female; Fusion Proteins, bcr-abl; antagonists & inhibitors; Hematopoietic Stem Cell Transplantation; Humans; Imatinib Mesylate; Male; Middle Aged; Philadelphia Chromosome; Piperazines; therapeutic use; Precursor Cell Lymphoblastic Leukemia-Lymphoma; diagnosis; genetics; therapy; Prognosis; Protein Kinase Inhibitors; therapeutic use; Pyrimidines; therapeutic use; Retrospective Studies; Young Adult
- From: Chinese Journal of Hematology 2014;35(2):109-113
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo explore the prognostic significance of Ph-positive and/or BCR-ABL positive acute lymphoblastic leukemia (Ph⁺ ALL).
METHODSA retrospective analysis of 72 patients with Ph⁺ ALL to probe prognostic factors including sex, age, high white cell counts at diagnosis, additional chromosome abnormality, BCR-ABL transcripts type, imatinib based therapy, allo-HSCT and complete remission (CR) after one-course induction on the outcomes of Ph⁺ALL patients.
RESULTSOf 72 patients with median age 40.5 (13-68) years, 38 patients received imatinib plus chemotherapy. With median follow-up of 11 (0.2-96) months, total CR rate in patients receiving imatinib plus chemotherapy was higher than of patients receiving chemotherapy only (97.4% vs 62.3%, P=0.019). High white blood counts at diagnosis or additional chromosome abnormality had no effects on CR rate. 2-year overall survival (OS) and disease free survival (DFS) in imatinib plus chemotherapy group were (28.9±7.4) % and (25±7.4) %, respectively, which were higher than those in chemotherapy group (P<0.001). OS rate in HSCT group was significantly higher than that in non-HSCT group[ (61.1±11.5) % vs (5.6±3.1) %, P<0.001]. Multivariate prognostic analysis for OS showed that imatinib-based therapy [RR=0.413 (95% CI 0.237-0.721), P=0.002], allo-HSCT [RR=0.175 (95% CI 0.075-0.389), P=0.000] and CR after one-course induction [RR=0.429 (95% CI 0.245-0.750), P=0.003] were of importance for survival.
CONCLUSIONallo-HSCT was an optimal choice for Ph⁺ALL patients. Imatinib-based therapy could increase CR rate, maintain CR duration and decrease relapse, resulting in more chance of HSCT. Imatinib improved the outcomes of Ph⁺ALL patients who were not eligible for HSCT.
