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对于移植后获得完全分子学缓解(CMR)的复发慢性髓性白血病患者是否需要伊马替尼维持治疗?一项初步回顾性研究。

Is Imatinib Maintenance Required for Patients with Relapse Chronic Myeloid Leukemia Post-Transplantation Obtaining CMR? A Pilot Retrospective Investigation.

作者信息

Jin Hua, Xiong Yiying, Sun Jing, Zhang Yu, Huang Fen, Zhou Hongsheng, Fan Zhiping, Xu Dan, Wei Yongqiang, Dai Min, Feng Ru, Liu Qifa

机构信息

Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

出版信息

PLoS One. 2013 Jun 18;8(6):e65981. doi: 10.1371/journal.pone.0065981. Print 2013.

Abstract

Imatinib can induce complete molecular remission (CMR) in relapse chronic myelogenous leukemia (CML) after allogeneic hematopoietic stem cell transplantation, but it is indefinite whether imatinib is required to maintain CMR. We retrospectively reviewed 37 relapse CML post-transplants treated with imatinib (n = 20) or donor lymphocyte infusion (DLI) (n = 17). The rate of CMR was 85% and 76.47% (P = 0.509) and treatment-related mortality was 0% and 29.4% (P = 0.019), respectively, in imatinib and DLI groups. Fifteen patients obtaining CMR voluntarily ceased imatinib, and did not experience relapse. The 8-year overall survival (OS) after relapse was 85%±8% and 40.3±12.1% (P = 0.017), and disease-free survival (DFS) after relapse was 85%±8% and 40.3±12.1% (P = 0.011), respectively, in imatinib and DLI groups. Imatinib resulted in higher OS and DFS than that of DLI in relapse CML. Imatinib maintenance might not be required for patients with relapse CML post-transplants after they achieved full donor chimerism and CMR.

摘要

伊马替尼可使异基因造血干细胞移植后复发的慢性粒细胞白血病(CML)患者获得完全分子缓解(CMR),但伊马替尼是否需要持续使用以维持CMR尚不明确。我们回顾性分析了37例移植后复发的CML患者,其中20例接受伊马替尼治疗,17例接受供者淋巴细胞输注(DLI)治疗。伊马替尼组和DLI组的CMR率分别为85%和76.47%(P = 0.509),治疗相关死亡率分别为0%和29.4%(P = 0.019)。15例获得CMR的患者自行停用伊马替尼,未出现复发。伊马替尼组和DLI组复发后的8年总生存率(OS)分别为85%±8%和40.3±12.1%(P = 0.017),复发后的无病生存率(DFS)分别为85%±8%和40.3±12.1%(P = 0.011)。在复发的CML患者中,伊马替尼治疗后的OS和DFS高于DLI。对于移植后复发的CML患者,在达到完全供者嵌合和CMR后,可能无需使用伊马替尼维持治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/434c/3688864/69ee75ab108c/pone.0065981.g001.jpg

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