甲磺酸伊马替尼与异基因造血干细胞移植治疗慢性髓性白血病患者的对比

Imatinib Mesylate Versus Allogeneic Hematopoietic Stem Cell Transplantation for Patients with Chronic Myelogenous Leukemia.

作者信息

Zhang Gui-Fang, Zhou Min, Bao Xie-Bing, Qiu Hui-Ying, Li Zheng, Xue Sheng-Li

机构信息

Leukemia Research Division, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of the Ministry of Health, First Af liated Hospital of Soochow University, Suzhou, China E-mail :

出版信息

Asian Pac J Cancer Prev. 2016;17(9):4477-4481.

PMID:27797264

Abstract

PURPOSE

To compare the relative merits of imatinib and allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myelogenous leukemia (CML).

MATERIALS AND METHODS

This cohort study was designed to compare the outcomes of imatinib (n=292) versus allo-HSCT (n=141) for CML, the clinical data of these patients being retrospectively analyzed so as to compare the event free survival (EFS) and overall survival (OS) between these two groups with patients in the chronic phase (CP) and advanced phases, including accelerate (AP) and blast phases (BP).

RESULTS

(1) Patients treated with imatinib (278 in the CP) demonstrated superior EFS, OS, 5-year EFS and 5-year OS rates of 88.5% versus 70.0% (P<0.05), 93.2% versus 80.0% (P<0.05), 84% versus 75.0% (P<0.05) and 92% versus 79.0% (P<0.05), respectively, to those treated with allo-HSCT (120 patients in the CP). (2) Both treatments resulted in similar survival, with EFS and OS rates of 42.9% versus 47.6% (P>0.05), 42.9% versus 57.1% (P>0.05), respectively, for imatinib (14 patients in the AP and BP) and allo-HSCT (21 patients in the AP and BP).

CONCLUSIONS

Imatinib confers signi cant survival advantage (EFS and OS) for CML patients with CP compared with allo-HSCT treatment. However, the outcomes are equally good with both treatments in AP and BP patients.

摘要

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）的相对优缺点。

材料与方法

本队列研究旨在比较伊马替尼（n = 292）与allo-HSCT（n = 141）治疗CML的疗效，对这些患者的临床数据进行回顾性分析，以比较这两组在慢性期（CP）以及加速期（AP）和急变期（BP）等进展期患者的无事件生存期（EFS）和总生存期（OS）。

结果

（1）接受伊马替尼治疗的患者（CP期278例）的EFS、OS、5年EFS和5年OS率分别为88.5%、93.2%、84%和92%，优于接受allo-HSCT治疗的患者（CP期120例），后者相应的比率分别为70.0%（P<0.05）、80.0%（P<0.05）、75.0%（P<0.05）和79.0%（P<0.05）。（2）两种治疗方法的生存期相似，伊马替尼组（AP期和BP期14例）和allo-HSCT组（AP期和BP期21例）的EFS率分别为42.9%和47.6%（P>0.05），OS率分别为42.9%和57.1%（P>0.05）。