伊马替尼与异基因造血干细胞移植治疗慢性髓性白血病回顾性分析

Outcomes of imatinib and allogeneic hematopoietic stem cell transplantation in the treatment ofchronic myeloid leukemia

目的比较伊马替尼与异基因造血干细胞移植（allo-HSCT）治疗慢性髓性白血病（CML）的疗效。方法回顾性分析292例接受伊马替尼治疗（伊马替尼组）和141例接受allo-HSCT（allo-HSCT组）CML患者的临床资料，分别比较两组慢性期、进展期（加速期和急变期）患者的无事件生存（EFS）率和总体生存（os）率。结果伊马替尼组慢性期CML患者（278例）的EFS率、OS率、预期5年EFS率、预期5年OS率均优于allo-HSCT组（120例）（88．5％对70．0％、93．2％对80．0％、84．0％对75．0％、92．0％对79．0％，P值均〈O．01）。伊马替尼组进展期CML患者（14例）的EFS率、OS率与allo-HSCT组（21例）比较，差异均无统计学意义（42．9％对47．6％，P=0．688；42．9％对57．1％，P=0．437）。结论伊马替尼治疗慢性期CML患者的EFS及OS率均优于allo-HSCT；对于加速或急变期患者，伊马替尼与allo-HSCT疗效相当。

Objective To compare the curative effect of imatinib and allogeneic hematopoietic stem cell transplant （allo-HSCT） in the treatment of chronic myeloid leukemia （CML）. Methods 292 CML patients received imatinib, and 141 patients underwent allo-HSCT. The clinical data of these patients were retrospectively analyzed to compare event-free survival （EFS） and overall survival （OS） between these two groups of paients in chronic and advanced （including accelerate and blast）phases. Results ① EFS, OS, expected 5-year EFS and OS of imatinib group （278 patients in chronic phase） were all statistically higher than of allo-HSCT group （120 patients in chronic phase） （88.5% vs 70.0%, 93.2% vs 80.0%, 84.0% vs 75.0% and 92.0% vs 79.0%, respectively, all P values 〈 0.01 ）. @EFS and OS of imatinib group （ 14 patients in accelerate and blast phases） were 42.9% and 42.9%, respectively. Meanwhile EFS and OS of allo-HSCT group （21 patients in accelerate and blast phases） were 47.6% and 57.1%, respectively. There were no significant differences in terms of EFS and OS between the two groups （P values 〉0.05）. Conclusions EFS and OS of imatinib group were significantly higher than of allo-HSCT group for CML patients of in chronic phase. Imatinib and allo-HSCT had the similar efficacy for CML patients in accelerate and blast phases.