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Objective: To analyze the clinical and biological characteristics, treatment effect and prognosis of 53 cases of Ph ~ - acute leukemia (AL) to explore its therapeutic strategy. Method: 2002 - 2008 were 53 cases of patients with Ph AL, MIC (M) standard diagnosis. Give VDCP ± L-asp ± cell Gleevec after induction therapy achieved complete remission, consolidation therapy the sequential application CAMML, high-dose MTX, MA (MTZ Arac) programs. Analysis of its clinical manifestations, hematological parameters, cytogenetics, molecular biology, naive cell surface antigen expression, treatment response rate, survival rate and recurrence-free survival. Statistical analysis SPSS13.0 statistical software. Multivariate analysis, the application of the Cox proportional hazards model, survival analysis applications Kaplan-Meier analysis for categorical variables X ~ 2 analysis applications, the continuous variable analysis using t test, variance analysis, non-parametric tests, multivariate analysis of categorical variables. Logistic Analysis. Results: 53 patients, male 33 cases, 20 females: median age 33 (14-58) years, median white blood cell count of 33.5 (1.1-681) × 10 ~ 9 / L. The 52 routine immunophenotyping patients, 19 patients were diagnosed as acute heterozygous cells leukocytes, 33 cases of B-acute lymphoblastic leukemia (ALL), all patients except one cases of acute heterozygous cell leukemia express CD10 antigen. Line karyotype examination in 45 patients with newly diagnosed, simple t (9; 22) 12 patients (26.7%), t (9; 22) chromosome abnormalities in 18 cases (40%) (normal karyotype 12 cases, variant The Ph chromosome abnormalities and other chromosomal abnormalities in four cases), t (9; 22) were accompanied by additional chromosomal abnormalities in 15 patients (33.3%). 48 patients for the first time visit line BCR / ABL fusion gene (P190, P210) detection, which 30/48 (62.5%) patients with pure P190 positive, 6/48 patients (12.5%) patients P190, P210 dual expression 12/48 patients (25%) patients with pure P210 positive. P210-positive patients than P190 average age of patients with positive. 37 patients underwent treatment, viable efficacy evaluation, which 32/37 patients (86.5%) patients achieved complete remission (CR). Induction period combined with Gleevec therapy the final efficacy for 16 patients evaluable patients, all of CR16 / 16 patients (100%); 17 cases of 16 cases of single treatment of chemotherapy-induced in 13 patients (86.7%) reached CR (P> 0.05 ); 5 cases did not reach remission induction chemotherapy refractory patients re-application the Gleevec response rate was 66.7%. 10/17 patients (58.8%) patients at a median application Gleevec combined with chemotherapy in the treatment of patients with previously untreated induced after the start of treatment (0.8-8.9) months fusion gene was negative. CR patients, median relapse-free survival time (RFS) was 19.8 months, 1 year, 2-year RFS rate was 58%, 29%, respectively; median overall survival (OS) was 28 months, 1 year, 2 years The overall survival rates were 67%, 43%. The 10 patients who underwent stem cell transplantation, the median time to CR to transplant 135 (59-305) days after transplantation median RFS was 10.5 months (2-26). Induction period in combination with Gleevec patients treated with induction therapy with chemotherapy alone in patients with OS were 28 months, 21.9 months (P> 0.05), RFS, respectively, for 29 months, 6.5 months (P <0.05). Conclusion: Ph AL men than women, white blood cell count higher; ALL is the most common, can be expressed as heterozygous with acute leukemia; fusion gene transcripts P190 expression more common. Gleevec combined with chemotherapy can improve the rate of complete remission, complete remission underwent allogeneic stem cell transplantation is the best treatment of patients with Ph ALL.
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