Uchida Tomoyuki, Doki Noriko, Kishida Yuya, Nagata Akihito, Yamada Yuta, Konishi Tatsuya, Kaito Satoshi, Kurosawa Shuhei, Yoshifuji Kota, Shirane Shuichi, Inamoto Kyoko, Toya Takashi, Igarashi Aiko, Najima Yuho, Muto Hideharu, Kobayashi Takeshi, Kakihana Kazuhiko, Sakamaki Hisashi, Ohashi Kazuteru
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital.
Rinsho Ketsueki. 2020;61(1):11-19. doi: 10.11406/rinketsu.61.11.
There have been many reports regarding tyrosine kinase inhibitor (TKI) administration to prevent relapse following allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL). However, there are no commonly accepted standards for the choice of TKIs. We retrospectively analyzed the clinical features of Ph+ALL patients who received TKIs after allo-HSCT at our institution. The prophylactic administration of TKIs (pro) occurred in eight patients, and six patients received preemptive TKI administration (pre). The median follow-up period after allo-HSCT was 1,427 (range, 161-2,428) days in the pro group and 773.5 (range, 156-2,243) days in the pre group. Only one patient with non-hematological complete remission before allo-HSCT relapsed among the patients in the pro group. In the pre group, four patients treated with only TKIs achieved negativity of minimal residual disease. The 2-year overall survival rate after allo-HSCT was 85.7% in the pro group and 100% in the pre group. We used lower doses of TKIs compared with previous reports and this analysis shows that the dose is safe and effective as the treatment.
关于对费城染色体阳性急性淋巴细胞白血病(Ph+ALL)患者进行异基因造血干细胞移植(allo-HSCT)后给予酪氨酸激酶抑制剂(TKI)以预防复发,已有许多报道。然而,对于TKI的选择尚无普遍接受的标准。我们回顾性分析了在我们机构接受allo-HSCT后接受TKI治疗的Ph+ALL患者的临床特征。预防性给予TKI(pro)的有8例患者,6例患者接受了抢先性TKI给药(pre)。allo-HSCT后的中位随访期在pro组为1427天(范围161 - 2428天),在pre组为773.5天(范围156 - 2243天)。pro组中仅1例在allo-HSCT前非血液学完全缓解的患者复发。在pre组中,4例仅接受TKI治疗的患者实现了微小残留病阴性。allo-HSCT后的2年总生存率在pro组为85.7%,在pre组为100%。与既往报道相比,我们使用的TKI剂量较低,且该分析表明该剂量作为治疗是安全有效的。