To compare the effect of the hematopoietic stem cell transplantation with and without imatinib to treat adult patients sufferred from Philadelphia chromosome-positive acute lymphocytic leukemia by evaluating the survival post-transplantation and the quality of life.
35 acute lymphocytic leukemia patients with Philadelphia chromosome-positive have taken hematopoietic stem cell transplantation between 2003 and 2011, in which 23 cases who were treated combined with imatinib were conducted in imatinib group, and the rest cases who haven't utilized imatinib were conducted in the control group. The incidence of relapse, incidence of graft-versus-host disease (GVHD), overall survival (OS) and disease-free survival (DFS) of the groups were compared so as to identify the advantage of combining treatment.
The age, gender, cytogenetic classification, doner type, preparative regimen and counts of stem cells were comparative between the two groups. The proportion of patients who were in the first remission (CR1) in the imatinib group was higher than that in control group, however, the single factor analysis showed that it didn't affect the survival significantly. The incidences of relapse were 17.4% in the imatinib group and 16.7% in the control group (P = 0.9569), and the incidences of acute GVHD of Grade II to Grade IV were 35.3% and 41.7% (P = 0.4506), respectively. The 2-year-OS of two groups showed statistical difference of 62.6% versus 41.7% (P = 0.028), and 2-year-DFS were 53.7% and 33.3% (P = 0.054), respectively. Patients who survived more than 2 years post-transplantation would have a favorable prognosis.
Patients of imatinib group had a better survival, but the incidences of relapses and severe GVHD between the two groups had no significant difference. Thus, patients of Philadelphia chromosome-positive acute lymphocytic leukemia may benefit from the combination of hematopoietic stem cell transplantation and imatinib.
No relevant conflicts of interest to declare.
Asterisk with author names denotes non-ASH members.