医学
达沙替尼
伊马替尼
淋巴细胞白血病
移植
肿瘤科
内科学
干细胞
造血干细胞移植
回顾性队列研究
费城染色体
白血病
髓系白血病
染色体易位
生物化学
化学
生物
基因
遗传学
作者
Fangshu Guan,Lifei Yang,Yi Chen,Jimin Shi,Xiaolu Song,Xiaoyu Lai,Ying Lu,Lizhen Liu,Guifang Ouyang,Yanmin Zhao,Jian Yu,Yang Xu,Jianping Lan,Haidong Fu,Yi Zhao,Xi Qiu,Panpan Zhu,Cai Zhang,He Huang,Yi Luo
出处
期刊:Cancer
[Wiley]
日期:2024-02-05
摘要
Abstract Background Although the prognosis of Philadelphia‐positive acute lymphoblastic leukemia (Ph+ ALL) has improved with the introduction of tyrosine kinase inhibitors (TKIs) and stem cell transplantation, prevention of relapse after transplantation remains a concern. The aim of this study was to compare the impact of TKI prophylaxis with imatinib and dasatinib on long‐term outcomes after transplantation. Methods Patients with Ph+ ALL who underwent allogeneic hematopoietic stem cell transplantation (allo‐HSCT) at first complete remission (CR1) and received TKI prophylaxis after allo‐HSCT were included in this retrospective analysis. Two cohorts were established based on the choice of TKI prophylaxis: the imatinib (Ima) and dasatinib (Das) cohorts. The survival and safety outcomes of these cohorts were compared. Results Ninety‐one patients in the Ima cohort and 50 in the Das cohort were included. After a median follow‐up of 50.6 months, the 5‐year cumulative incidence of relapse, nonrelapse mortality rate, and overall survival in the Ima and Das cohorts were 16.1% and 12.5%, 5.2% and 9.8%, and 86.5% and 77.6%, respectively, with no statistical differences. The cumulative incidence of mild chronic graft‐versus‐host disease was higher in the Das cohort. The most common adverse event was neutropenia (64.7% vs. 69.5%). The Das cohort had a higher incidence of gastrointestinal bleeding (25.5% vs. 2.3%) and gastrointestinal reaction (48.9% vs. 31.4%) than the Ima cohort. The proportion of patients treated on schedule was significantly lower in the Das cohort than in the Ima cohort, and drug intolerance was the main reason for protocol violation. Conclusions For patients with Ph+ ALL undergoing allo‐HSCT in CR1, imatinib prophylaxis achieved long‐term outcomes similar to those of dasatinib.
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