伊马替尼联合化疗治疗初治BCR/ABL阳性急性淋巴细胞白血病的临床分析

Imatinib in Combination with Chemotherapy in Treatment of BCR/ABL-Positive Acute Lymphoblastic Leukemia

目的:探讨伊马替尼联合化疗治疗初治BCR/ABL+-急性淋巴细胞性白血病(ALL)的疗效。方法:我院2004年1月至2009年1月荧光原位杂交检查确诊为初治BCR/ABL+-ALL48例,随机分为两组,治疗组24例,用VDLP加伊马替尼方案诱导化疗,对照组24例单用VDLP方案诱导化疗,治疗组完全缓解后伊马替尼与化疗交替进行巩固及强化治疗,对照组单用化疗进行巩固及强化治疗。结果:治疗组经第1疗程诱导治疗后获完全缓解率(CR)共20例(83.3%),对照组经第1疗程诱导治疗后获CR共13例(54.2%),(P<0.05)。治疗组20例完全缓解的患者,中位缓解期13(7～19)个月,对照组13例CR,中位缓解期6(3～9)个月(P<0.05)。含伊马替尼治疗组与不含伊马替尼治疗组2a总生存率(OS)分别是45.8%和12.5%(P<0.05)。结论:伊马替尼联合化疗诱导治疗BCR/ABL+-ALL,CR较常规化疗明显提高。化疗与伊马替尼交替进行巩固及强化治疗,中位缓解时间及生存时间也较单用化疗明显延长。

Objective:To study the efficacy of Im-atinib in combination with chemotherepy in treatment of BCR/ABL+-ALL . Methods:From January 2004 to January 2009, 48 patients with the diagnosis of BCR/ABL+-ALL by fluorescence in situhybridization. The treatment group(24 cases) are received induction chemotherapy with VDLP in combination with imatinib (400-800 mg/day). The control group(24 cases) are received in-duction chemotherapy with VDLP. The patients of treatment group subsequently consolidation and maintenance therapy were started with imatinib and chemotherapy by turns after complete remission. The patients of control group subsequently consolidation and maintenance therapy were started with chemotherapy after complete remission. Results:Of the 48 patients, in the treatment group 20 (83.3%) achieved complete remission (CR) after the first induction cycle, and in control group patients 13(54.2%)achieved CR (P <0.05). In the treatment group estimated median remission duration was 13( 7～19) months, in the control group estimated median remission duration was 6(3～9) months(P <0.05). Conclu-sion:In patients with BCR/ABL+-ALL given imatinib in com-binaion with chemotherapy, CR rate is a significantly higher than that of conventional chemotherapy. In consolidation therapy with Imatinib and chemotherapy alternately, median remission and sur-vival duration is improved compared with the chemotherapy.