title: Sustaining integrating imatinib and interferon-α into maintenance therapy improves survival of patients with Philadelphia positive acute lymphoblastic leukemia ineligible for allogeneic stem cell transplantation.
abstract: We report the clinical results of sustainedly integrating imatinib and interferon-α into maintenance therapy in the patients ineligible for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Maintenance therapy lasted for 5 years with imatinib 400 mg daily, interferon-α 3 million units, 2∼3 doses per week, and chemotherapy including vindesine and dexamethasone scheduled monthly in first year, once every 2 months in second year, and once every 3 months in third year. The chemotherapy was discontinued after 3 years and the imatinib and interferon-α continued for another 2 years. For 41 patients without allo-HSCT with a median follow-up of 32 months, the 3-year DFS and OS were 42.7  ± 8.6% and 57.9  ± 8.4%, respectively. Our study suggests that sustaining maintenance with low-dose chemotherapy, imatinib and interferon-α improved survival of adult Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL) patients ineligible for allo-HSCT, and even provided an opportunity for cure. BCR/ABL persistent negativity at 6 and 9 months may have benefit to choose suitable patients for the imatinib/interferon-α maintenance strategy.
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Pu
authors.initials: P
authors.lastname: Kuang
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Ting
authors.initials: T
authors.lastname: Liu
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Ling
authors.initials: L
authors.lastname: Pan
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Huanling
authors.initials: H
authors.lastname: Zhu
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Yu
authors.initials: Y
authors.lastname: Wu
authors.affiliation: b Department of Laboratory Medicine , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Yuanxin
authors.initials: Y
authors.lastname: Ye
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Bing
authors.initials: B
authors.lastname: Xiang
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Hongbing
authors.initials: H
authors.lastname: Ma
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Hong
authors.initials: H
authors.lastname: Chang
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Ting
authors.initials: T
authors.lastname: Niu
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Xu
authors.initials: X
authors.lastname: Cui
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Chuan
authors.initials: C
authors.lastname: He
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Jianjun
authors.initials: J
authors.lastname: Li
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Jie
authors.initials: J
authors.lastname: Ji
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Jie
authors.initials: J
authors.lastname: Huang
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Tian
authors.initials: T
authors.lastname: Dong
authors.affiliation: a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Yang
authors.initials: Y
authors.lastname: Dai
authors.affiliation: b Department of Laboratory Medicine , West China Hospital of Sichuan University , Chengdu , PR China ;
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Lu
authors.affiliation: c Department of Hematology , People's Hospital of Deyang , Deyang , PR China ;
authors.forename: Shenglan
authors.initials: S
authors.lastname: Qing
authors.affiliation: d Department of Hematology , Central Hospital of Mianyang , Mianyang , PR China ;
authors.forename: Huaxin
authors.initials: H
authors.lastname: Wu
authors.affiliation: d Department of Hematology , Central Hospital of Mianyang , Mianyang , PR China ;
authors.forename: Xiaogong
authors.initials: X
authors.lastname: Liang
authors.affiliation: e Department of Hematology , the 3rd People's Hospital of Chengdu , Chengdu , PR China ;
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Wang
authors.affiliation: f Department of Hematology , the First Hospital of Liangshan , Xichang , PR China.
authors.forename: Chunnong
authors.initials: C
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage; D016898:Interferon-alpha / Q000008:administration & dosage; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D012074:Remission Induction; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D016898:Interferon-alpha; D000068877:Imatinib Mesylate
keywords: Imatinib; Philadelphia chromosome positive acute lymphoblastic leukemia; interferon-α; long-term survival; maintenance therapy