Objective: To report the efficacy and safety of imatinib plus Hyper-CVAD chemotherapy regimen in the treatment of patients with ph chromosome positive acute lymphocytic leukemia (Ph(+)ALL).
Methods: A sequential 2-year and 8-cycle treatment of imatinib plus Hyper-CVAD (A/B program) was administrated in 18 Ph(+)ALL patients treated at our hospital since January 2005 to January 2010. And another 18 Ph(+)ALL patients undergoing no allogeneic hematopoietic stem cell transplantation were selected as controls.
Results: Among 18 patients on chemotherapy, their average age was 33.1 years, the total response rate 100% following induction chemotherapy and the median survival 28.8 (8.0 - 60.0) months. And the 1-, 2- and 3-year overall survival rates were 77.8%, 72.2% and 66.7% respectively. In control patients, the response rate following induction chemotherapy was 100% and the median survival 22.5 (4.0 - 58.0) months. And the 1-, 2- and 3-year overall survival rates were 66.7%, 55.6% and 50.0% respectively. A recent follow-up showed that 5 patients (27.8%) died from relapse in the chemotherapy group and 4 (22.2%) in the control group. The overall deaths were 6 (33.3%) in the chemotherapy group and 9 (50.0%) in the control group.
Conclusion: Imatinib plus Hyper-CVAD chemotherapy regimen is associated with significantly improved survival rates. Superior to allogeneic hematopoietic stem cell transplantation, it offers a prolonged median response time and survival time in Ph(+)ALL patients.