Combined intensive preconditioning regimen allo－HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia

Luo Yi(羅 毅，Inst Hematol，Union Hosp，Tongji Med Col，Huazhong Univ Sci Technol，Wuhan 430022)…∥Chin J Organ Transplant.－2011，32(3).－137～140

Combined intensive preconditioning regimen allo－HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia

Luo Yi(羅 毅，Inst Hematol，Union Hosp，Tongji Med Col，Huazhong Univ Sci Technol，Wuhan 430022)…∥Chin J Organ Transplant.－2011，32(3).－137～140

ObjectiveTo evaluate the outcome of combination of intensive preconditioning regimen allo－HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia(ALL).MethodsBetween 2009 and 2010，8 patients diagnosed as Ph+ALL received allo－HSCT from HLA identical sibling during complete remission.Imatinib was added into the therapies of 5 patients.Seven patients received the intensive preconditioning regimen based on BuCy2，one patient received the regimen of TBI－ Cy.A median of 6.02 ×108/kg mononuclear cells and 3.14 × 106/kg CD34+cells were transfused.GVHD prophylaxis included cyclosporine A and methotrexate.ResultsAll patients were well tolerant to the regimen without serious regimen－related toxicity.The median time of ANC≥0.5× 109/L was 15.5 days，and that of PLT≥20 × 109/L was 19 days.Thirty days after allo－HSCT，all patients got donor engraftment successfully.Among 8 cases，4 cases presented acute GVHD，2 developed degreeⅠ，one developed degreeⅡ，and one developed degreeⅣ.Seven patients survived 100 days after allo－HSCT，3 of whom presented chronic GVHD.At the end of following－up period，6 patients survived，among them，3 patients survived without relapsel 3 patients relapsed;Two patients died，one from acute GVHD，and one from leukemia relapse.ConclusionCombined intensive preconditioning regimen allo－HSCT with Imatinib was an effective treatment for Ph+ALL，but the effect of anti－chronic GVHD of imatinib should be attended.17 refs，2 tabs.

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