Imatinib(Gleevec)in preparation for allogeneic hematopoietic stem cell transplantation in patients with Philadelphia-positive leukemia
- VernacularTitle:Ph染色体阳性白血病患者经伊马替尼治疗后行异基因造血干细胞移植的疗效观察
- Author:
Wei HAN
;
Xiaojun HUANG
;
Kaiyan LIU
- Publication Type:Journal Article
- Keywords:
Leukemia;
Hematopoietic stem cell transplantation;
Chromosome,Ph;
Imatinib mesylate
- From:
Chinese Journal of Practical Internal Medicine
2006;0(14):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively analyse the impact of imatinib mesylate(Gleevec)on HSCT outcome in patients with Ph(+)leukemias.Methods From June 2001 to June 2005,31 CML-BC/AP patients and 8 refractory Ph(+)ALL patients were treated with imatinib mesylate to induce remission,followed by allogeneic transplantation,and we evaluated its influence on engraftment,graft versus host disease(GVHD),overall survival(OS),disease free survival(DFS),relapse rate(RR)and transplant-related mortality(TRM).Results Eighteen of 39 patients achieved complete hematologic remission(CHR),9 patients bone marrow remission(BMR)and 4 patients partial response(PR),the overall response rate being 70.96%.After HSCT,all patients achieved complete allogeneic engraftment with a median of 14 and 13.5 days for neutrophil and platelet recovery,respectively.The cumulative incidence rates of Ⅱ~Ⅳ? and Ⅲ~Ⅳ? aGVHD were 61.53% and 15.38%.The probability of OS and DFS was(73.51?9.61)% and(61.28?12.37)%,when HSCT was performed in CR,compared with(36.36?14.50)% and(31.25?13.98)% in NR.The 3-year cumulative relapse rate(RR)was 20.41% vs 75.00%.Four cases died of transplant-related complications.Conclusion Pre-transplant imatinib mesylate seems effective and safe for refractory Ph(+)leukemias;it allows transplantation to be in a more favorable status,and leads to better outcome.
