Efficacy and prognosis of tyrosine kinase inhibitors combined with chemotherapy in the treatment of adult Philadelphia chromosome-positive acute lymphoblastic leuk-emia
10.12354/j.issn.1000-8179.2024.20240111
- VernacularTitle:TKIs联合化疗治疗成人Ph阳性急性淋巴细胞白血病的疗效及预后分析
- Author:
Ma XIAONAN
1
;
Zheng BO
Author Information
1. 宁夏医科大学总医院血液内科(银川市 750004);宁夏医科大学临床医学院
- Keywords:
acute lymphoblastic leukemia(ALL);
Philadelphia chromosome positive;
tyrosine kinase inhibitors(TKI);
chemotherapy
- From:
Chinese Journal of Clinical Oncology
2024;51(6):287-292
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and prognosis of induction therapy combined with chemotherapy and tyrosine kinase inhib-itors(TKI)in adult Philadelphia chromosome-positive acute lymphoblastic leukemia(Ph+ALL).Methods:This study retrospectively analyzed the clinical features,biological characteristics,complete remission,curative effect,and prognosis of 60 adult patients with Ph+ALL treated in GeneraI Hospital of Ningxia Medical University from January 2012 to October 2023.Results:Among the patients,43(71.67%,43/60)achieved complete remission(CR)after the first induction therapy,including 7(41.18%,7/17)in the chemotherapy-alone group and 36(83.72%,36/43)in the TKI-plus-chemotherapy group(P=0.003).The 2-year overall survival(OS)rate of patients in the chemotherapy-alone group(28.2%)was significantly less than that of patients in the TKI-plus-chemotherapy group(56%,P=0.041).In the transplant and non-transplant groups,the 2-year and 5-year OS rates were 76.9%vs.51.9%,56.1%vs.19.4%,respectively(P=0.003).The 2-year progression-free survival(PFS)rate was better in the transplant group(38.5%)than in the non-transplant group(12.1%,P=0.018).Univariate prognostic analysis showed that whether TKI was selected,whether CR was obtained after the initial induction therapy,and whether bone marrow transplantation was performed,significantly affected OS prognosis(P<0.05).The white blood cell count and whether TKI was selected signi-ficantly affected the relapse-free survival(RFS)of patients(P<0.05).Cox multivariate prognostic analysis showed that CR,after induction therapy,and subsequent hematopoietic stem cell transplantation were independent prognostic factors for OS.Conclusions:In the Ph+ALL in-duction therapy regimens,TKI-plus-chemotherapy induction therapy can achieve early remission and a high remission rate,and the OS is better than chemotherapy alone.After CR,bone marrow hematopoietic stem cell transplantation for Ph+ALL had a good prognosis.
