title: [Efficacies of hematopoietic stem cell transplantation plus imatinib in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia: a comparative study].
abstract: OBJECTIVE
  To compare the efficacies of hematopoietic stem cell transplantation with and without imatinib in the treatment of adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia by evaluating the post-transplantation survival and quality-of-life.
  
  
  METHODS
  A total of 35 acute lymphoblastic leukemia patients with Philadelphia chromosome-positive underwent hematopoietic stem cell transplantation from 2003 to 2011. They were divided into the imatinib (n = 23) and control (n = 12) groups. The incidence of graft-versus-host disease (GVHD), overall survival (OS), disease-free survival (DFS) and non-relapse mortality (NRM) of two groups were compared to identify the superiority of combined treatment.
  
  
  RESULTS
  Age, gender, cytogenetic classification, donor type, proposed regimen and counts of infused stem cells were comparable between two groups. The proportion of patients in the first remission (CR1) in the imatinib group was higher than that in control group (20/23 vs 6/12, P = 0.038). However, single factor analysis showed that it did not affect the survival significantly (P = 0.884, 0.924). The estimated incidence of acute GVHD was 45.5% in the imatinib group versus 66.7% in the control group (P = 0.386). And the incidence of acute GVHD of Grades II-IV were 26.1% and 41.7% (P = 0.349) respectively. The estimated 5-year OS of two groups showed statistical difference (62.6% vs 41.7%, P = 0.028) and estimated 5-year DFS were 53.7% and 33.3% respectively (P = 0.054). The 5-year NRM was 41.7% in the control group and the main causes were infection and severe GVHD versus 22.7% in the imatinib group (P = 0.084) and the main cause was infection. The engraftment of white blood cell (median time: 13 vs 11 days, P = 0.008) and platelet (median time: 14 vs 11 days, P = 0.002) was delayed in imatinib group compared with control group.
  
  
  CONCLUSIONS
  The patients of Philadelphia chromosome-positive acute lymphoblastic leukemia may acquire a better survival from the combined regimen of hematopoietic stem cell transplantation and imatinib, without increasing the hazard of acute GVHD and NRM.
authors.affiliation: Jiangsu Institute of Hematology, Department of Hematology, First Affiliated Hospital of Soochow University, Key Lab of Thrombosis & Hemostasis, Ministry of Health, Suzhou 215006, China. c_jerry_j@163.com
authors.forename: Jia
authors.initials: J
authors.lastname: Chen
authors.forename: De-pei
authors.initials: DP
authors.lastname: Wu
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhao
authors.forename: Ai-ning
authors.initials: AN
authors.lastname: Sun
authors.forename: Hui-ying
authors.initials: HY
authors.lastname: Qiu
mesh_terms: D000293:Adolescent; D000328:Adult; D001549:Benzamides / Q000627:therapeutic use*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D010879:Piperazines / Q000627:therapeutic use*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000628:therapy*; D011743:Pyrimidines / Q000627:therapeutic use*; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate