title: [Outcomes of younger than 60 years old adults with Ph/BCR-ABL positive acute lymphoblastic leukemia: a single center clinical trial of BDH ALL 2000/02].
abstract: OBJECTIVE
  To explore the treatment options for younger than 60 years old adults with Ph /BCR-ABL positive acute lymphoblastic leukemia (Ph⁺ ALL).
  
  
  METHODS
  From January 2001 to June 2012, 42 adult patients were enrolled in the study. All patients received standard VDCP±L ±imatinb (IM) as induction therapy followed by intensive consolidation of modified Hyper-CVAD/MA±IM. At complete remission 1 (CR1), patients with appropriate donor received allogeneic hematopoietic stem cell transplantation (allo-HSCT), the others sequentially received intensive consolidation ±IM and autologous HSCT (ASCT) at molecular CR (MCR), then MM±VP±IM as maintenance therapy. Overall survival (OS), disease free survival (DFS) and relapse rate (RR) were analyzed.
  
  
  RESULTS
  CR rate after 1 cycle of induction chemotherapy was 83.3%. 39(92.9%) patients achieved CR. The median DFS and OS were (22.0±3.5) and (37.0±5.3) months respectively, with cumulative RR of (43.7±9.7)% during a median follow-up of 26.5(8-75) months. All 7 patients in CT group relapsed. Two patients received IM pre- and post-ASCT maintained MCR for 35 and 12 months after ASCT. But the other 3 ASCT recipients without IM died of relapse within 1 year. The transplant-related mortality rate in allo-HSCT group was 12.5%. The estimated 3-year OS in allo-HSCT (n=16), ASCT (n=5) and CT (n=7) groups were (66.7±12.2)%, (25.0±21.7)% and (16.7±15.2)%, respectively (P=0.014); meanwhile, the estimated 3-year DFS in those groups were of (56.3±12.4)%, (26.7±22.6)% and 0, respectively (P=0.002).
  
  
  CONCLUSIONS
  IM combined with intensive chemotherapy significantly increased the CR rate with the improved quality of CR, which highlighted the feasibility of SCT. Allo-HSCT could decrease relapse to produce favorable OS and DFS in CR1 of young adults with Ph⁺ ALL. ASCT combined IM might be the treatment of choice for those achieved MCR but without donors.
authors.affiliation: State Key Laboratory of Experimental Hematology,Institute of Hematology & Blood Diseases Hospital,CAMS & PUMC, Tianjin 300020, China.
authors.forename: Yan-ru
authors.initials: YR
authors.lastname: Zhang
authors.forename: Ting-yu
authors.initials: TY
authors.lastname: Wang
authors.forename: De-hui
authors.initials: DH
authors.lastname: Zou
authors.forename: Wei-wei
authors.initials: WW
authors.lastname: Sui
authors.forename: Zeng-jun
authors.initials: ZJ
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.forename: Ming-wei
authors.initials: MW
authors.lastname: Fu
authors.forename: Yao-zhong
authors.initials: YZ
authors.lastname: Zhao
authors.forename: Jun-yuan
authors.initials: JY
authors.lastname: Qi
authors.forename: Jian-xiang
authors.initials: JX
authors.lastname: Wang
authors.forename: Ying-chang
authors.initials: YC
authors.lastname: Mi
authors.forename: Lu-gui
authors.initials: LG
authors.lastname: Qiu
mesh_terms: D000293:Adolescent; D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult