Raissi Abderrahim, Bouaouad Majdouline, Drideb Noufissa Alami, Jennane Selim, Mahtat El Mahdi, Doghmi Kamal, Mikdame Mohammed
Service d'hématologie clinique, Hôpital militaire d'instruction Mohamed V, Rabat, Maroc.
Ann Biol Clin (Paris). 2015 Mar-Apr;73(2):195-8. doi: 10.1684/abc.2015.1039.
Philadelphia or BCR-ABL positive acute lymphoblastic leukemia (PH+ ALL) is the most common and severe of adult ALL. The only potentially curator treatment remains allogeneic hematopoietic stem cells transplantation (SCT) in first complete remission. The use of imatinib has revolutionized the treatment of chronic myeloid leukemia. Its incorporation into PH + ALL protocols also improved the prognosis of this disease giving better complete remission rates compared to chemotherapy alone. The treatment of patients not eligible for SCT remains controversial. Prolonged use of high dose tyrosine kinase inhibitors (TKI) (ie: imatinib at 600 or 800 mg/j) as maintenance therapy seems to be a reasonable approach. We present a case of prolonged molecular remission of PH+ ALL under TKI alone as maintenance therapy.
费城或BCR-ABL阳性急性淋巴细胞白血病(PH+ ALL)是成人ALL中最常见且最严重的类型。唯一可能治愈的治疗方法仍然是在首次完全缓解时进行异基因造血干细胞移植(SCT)。伊马替尼的使用彻底改变了慢性髓性白血病的治疗。将其纳入PH + ALL方案也改善了该疾病的预后,与单纯化疗相比,完全缓解率更高。对于不符合SCT条件的患者的治疗仍存在争议。长期使用高剂量酪氨酸激酶抑制剂(TKI)(即:600或800毫克/天的伊马替尼)作为维持治疗似乎是一种合理的方法。我们报告了一例仅使用TKI作为维持治疗而实现PH+ ALL长期分子缓解的病例。