%0 Journal Article
%T Administration of imatinib after allogeneic hematopoietic stem cell transplantation may improve disease-free survival for patients with Philadelphia chromosome-positive acute lymphobla stic leukemia
%A Huan Chen
%A Kai-yan Liu
%A Lan-ping Xu
%A Dai-hong Liu
%A Yu-hong Chen
%A Xiang-yu Zhao
%A Wei Han
%A Xiao-hui Zhang
%A Yu Wang
%A Yuan-yuan Zhang
%A Ya-zhen Qin
%A Yan-rong Liu
%A Xiao-jun Huang
%J Journal of Hematology & Oncology
%D 2012
%I BioMed Central
%R 10.1186/1756-8722-5-29
%X Patients with Ph£¿+£¿ALL that received allo-HCT were enrolled in the study. Real-time quantitative reverse-transcription polymerase chain reaction (qRT-PCR) was used to detect BCR-ABL transcript levels. Imatinib therapy was initiated if patient neutrophil counts were£¿>£¿1.0£¿¡Á£¿109/L and platelet counts were£¿>£¿50.0£¿¡Á£¿109/L, or if they displayed either elevated BCR-ABL transcript levels in two consecutive tests, or a BCR-ABL transcript level£¿¡Ý£¿10-2 after initial engraftment. Patients receiving imatinib after relapse were assigned to the non-imatinib group. The imatinib treatment was scheduled for 3¨C12£¿months, until BCR-ABL transcript levels were negative at least for three consecutive tests or complete molecular remission was sustained for at least 3£¿months.A total of 82 patients were enrolled. Sixty-two patients initiated imatinib therapy post-HCT. Imatinib therapy was initiated at a median time of 70£¿days post-HCT. Grade 3¨C4 adverse events (AEs) occurred in 17.7% of patients. Ten patients (16.1%) terminated imatinib therapy owing to AEs. Among the patients in imatinib and non-imatinib groups, the estimated 5-year relapse rate was 10.2% and 33.1% (p£¿=£¿0.016), and the 5-year probability of DFS was 81.5% and 33.5% (p£¿=£¿0.000) with the median follow-up of 31£¿months (range, 2.5-76£¿months) and 24.5£¿months (range, 4¨C72£¿months), respectively. Multivariate analysis identified imatinib maintenance therapy post-HCT as an independent prognostic factor for DFS (p£¿=£¿0.000, hazard ratio [HR] =4.8) and OS (p£¿=£¿0.000, HR£¿=£¿6.2).These results indicate that relapse rate can be reduced and DFS may be improved in Ph£¿+£¿ALL patients with imatinib maintenance therapy after HCT. BCR-ABLmonitoring by qRT-PCR can guide maintenance therapy with imatinib including initiation time and treatment duration after allo-HCT.
%K Philadelphia chromosome
%K Acute lymphoblastic leukemia
%K Allogeneic hematopoietic cell transplantation
%K Minimal residual disease
%K Imatinib
%U http://www.jhoonline.org/content/5/1/29/abstract