Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2015
[Outcome of patients with adult acute lymphoblastic leukemia between 2000 and 2013: experience from single center].
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Jing, Jiang Bin, Liu Kaiyan, Xu Lanping, Zhang Xiaohui, Chen Huan, Jia Jinsong, Yang Shenmiao, Bao Li, Jiang Hao, Lu Jin, Zhu Honghu, Zhao Ting, Huang Xiaojun, Jiang Qian
Аннотация
OBJECTIVE: To compare the outcomes of patients with adult acute lymphoblastic leukemia (ALL) over the last 14 years by taking 2006 as the demarcation point.
METHODS: From January 2000 to December 2013, 477 consecutive hospitalized patients with adult ALL were retrospectively analyzed, including 276 (57.9%) with Ph negative B-ALL (Ph⁻-B-ALL) B-ALL, 69 (14.5%) with T-ALL and 132 (27.7%) with Ph positive ALL (Ph⁺-ALL); 111 (23.3%) before 2006 and 366 (76.7%) after 2006. Among 435 patients who achieved complete remission (CR), 248 (57.0%) received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and 187 remained on chemotherapy.
RESULTS: With a median follow-up period of 19 months in all patients and 35 months in living patients, overall CR rate was 92.0%. Of 435 CR patients, the cumulative incidences of 5-year relapse, disease-free survival( DFS) and overall survival (OS) rates were 42.5%, 46.2% and 47.6%, respectively. Compared with the patients hospitalized before 2006: ① the Ph+-ALL patients hospitalized after 2006 achieved a higher overall CR rate (P=0.036). There was no difference for CR rates of Ph--B-ALL and T-ALL patients between before and after 2006. ②The CR patients hospitalized after 2006 had higher 5-year DFS and OS rates (P=0.001; P < 0.001), including higher 5-year OS rate in Ph⁻-B-ALL patients (P=0.046), and higher 5-year DFS and OS rates in both T-ALL (P=0.013; P=0.036) and Ph⁺-ALL patients (P=0.003; P < 0.001) , especially in those Ph⁺-ALL patients who received imatinib from the beginning of the induction chemotherapy (P < 0.001; P < 0.001) ③The patients who received allo-HSCT after 2006 had higher 5-year DFS and OS rates (P=0.001; P < 0.001), but there was no difference for the outcomes in those who remained on chemotherapy before and after 2006. After 2006, Ph⁺-ALL patients who received imatinib from the beginning of the induction chemotherapy had the highest 5-year DFS and OS rates compared with Ph⁻-B-ALL and T-ALL patients (P=0.009; P=0.001) . Multivariate analysis showed that allo-HSCT and imatinib were two important factors affecting the outcomes of ALL patients.
CONCLUSION: The outcomes of ALL patients improved significantly over the last 14 years, especially in Ph⁺-ALL ones.
METHODS: From January 2000 to December 2013, 477 consecutive hospitalized patients with adult ALL were retrospectively analyzed, including 276 (57.9%) with Ph negative B-ALL (Ph⁻-B-ALL) B-ALL, 69 (14.5%) with T-ALL and 132 (27.7%) with Ph positive ALL (Ph⁺-ALL); 111 (23.3%) before 2006 and 366 (76.7%) after 2006. Among 435 patients who achieved complete remission (CR), 248 (57.0%) received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and 187 remained on chemotherapy.
RESULTS: With a median follow-up period of 19 months in all patients and 35 months in living patients, overall CR rate was 92.0%. Of 435 CR patients, the cumulative incidences of 5-year relapse, disease-free survival( DFS) and overall survival (OS) rates were 42.5%, 46.2% and 47.6%, respectively. Compared with the patients hospitalized before 2006: ① the Ph+-ALL patients hospitalized after 2006 achieved a higher overall CR rate (P=0.036). There was no difference for CR rates of Ph--B-ALL and T-ALL patients between before and after 2006. ②The CR patients hospitalized after 2006 had higher 5-year DFS and OS rates (P=0.001; P < 0.001), including higher 5-year OS rate in Ph⁻-B-ALL patients (P=0.046), and higher 5-year DFS and OS rates in both T-ALL (P=0.013; P=0.036) and Ph⁺-ALL patients (P=0.003; P < 0.001) , especially in those Ph⁺-ALL patients who received imatinib from the beginning of the induction chemotherapy (P < 0.001; P < 0.001) ③The patients who received allo-HSCT after 2006 had higher 5-year DFS and OS rates (P=0.001; P < 0.001), but there was no difference for the outcomes in those who remained on chemotherapy before and after 2006. After 2006, Ph⁺-ALL patients who received imatinib from the beginning of the induction chemotherapy had the highest 5-year DFS and OS rates compared with Ph⁻-B-ALL and T-ALL patients (P=0.009; P=0.001) . Multivariate analysis showed that allo-HSCT and imatinib were two important factors affecting the outcomes of ALL patients.
CONCLUSION: The outcomes of ALL patients improved significantly over the last 14 years, especially in Ph⁺-ALL ones.
Предметные рубрики MeSH
Acute DiseaseAdultDisease-Free SurvivalHematopoietic Stem Cell TransplantationHumansImatinib MesylateInduction ChemotherapyMultivariate AnalysisPrecursor Cell Lymphoblastic Leukemia-LymphomaPrecursor T-Cell Lymphoblastic Leukemia-LymphomaRecurrenceRemission InductionRetrospective StudiesSurvival Rate