Bittencourt H, Funke V, Fogliatto L, Magalhães S, Setubal D, Paz A, Macedo A V, Ruiz J, Azambuja A P, Silla L, Clementino N, Pasquini R
Hematology and Stem Cell Transplantation Service, Hospital das Clinicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Bone Marrow Transplant. 2008 Nov;42(9):597-600. doi: 10.1038/bmt.2008.218. Epub 2008 Aug 4.
Imatinib mesylate (IM) is now first-line treatment for CML. To study the results of treatment with IM after IFN failure/intolerance versus allogeneic BMT (allo-BMT), we retrospectively analyzed 264 patients treated for CML in first chronic phase in three different institutions. Over a 6-year period (2001-2006), 174 patients received IM after failure of or intolerance to IFN. During the same period of time, 90 patients received an allo-BMT from an HLA-matched sibling (n=83) or an unrelated donor (n=7). The IM group was older (41 versus 33 years, P<0.001). Five-year EFS was 62% among patients receiving IM and 52% among patients undergoing allo-BMT (P=0.0002). OS at 5 years was 93% for IM-treated patients and 59% for patients undergoing allo-BMT (P<0.0001). Allo-BMT cannot be considered as first-line treatment for CML patients in first chronic phase.
甲磺酸伊马替尼（IM）目前是慢性粒细胞白血病（CML）的一线治疗药物。为了研究在干扰素（IFN）治疗失败/不耐受后使用IM治疗与异基因骨髓移植（allo - BMT）的疗效，我们回顾性分析了在三个不同机构接受首次慢性期CML治疗的264例患者。在6年期间（2001 - 2006年），174例患者在IFN治疗失败或不耐受后接受了IM治疗。在同一时期，90例患者接受了来自HLA匹配同胞（n = 83）或无关供体（n = 7）的allo - BMT。IM组患者年龄更大（41岁对33岁，P < 0.001）。接受IM治疗的患者5年无事件生存率（EFS）为62%，接受allo - BMT的患者为52%（P = 0.0002）。接受IM治疗的患者5年总生存率（OS）为93%，接受allo - BMT的患者为59%（P < 0.0001）。对于处于首次慢性期的CML患者，allo - BMT不能被视为一线治疗方法。
