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[Comparison of clinical efficacy between first-generation and second-generation tyrosine kinase inhibitors based regimen in the treatment of patients with BCR-ABL positive acute lymphoblastic leukemia].
Liu, Y; Mi, R H; Chen, L; Yuan, F F; Yin, Q S; Fu, Y W; Zhu, X H; Liu, X J; Zhang, Y L; Zhang, W L; Wei, X D.
Afiliação
  • Liu Y; Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Henan Provincial Tumor Hospital, Zhengzhou 450008, China.
Zhonghua Xue Ye Xue Za Zhi ; 40(9): 738-743, 2019 Sep 14.
Article em Zh | MEDLINE | ID: mdl-31648474
ABSTRACT

Objective:

To explore the clinical efficacy and prognostic factors of first-generation and second-generation tyrosine kinase inhibitors (TKI) based regimen in the treatment of patients with BCR-ABL positive acute lymphoblastic leukemia (ALL) .

Methods:

Retrospectively analyze the clinical characteristics and prognostic factors of 89 patients with BCR-ABL positive ALL from April 2012 to June 2018 in our hospital, the clinical efficacy of first-generation and second-generation TKI was compared.

Results:

60 patients were classified into the first-generation TKI (imatinib) group, and 29 patients were in the second-generation TKI (dasatinib) group. There were no significant differences in gender, age, WBC, hemoglobin concentration, PLT, chromosomal karyotype, the types of fusion genes, allogeneic hematopoietic stem cell transplantation (allo-HSCT) and TKI initiation time between the two groups. The first-generation and second-generation TKI groups, for which the complete remission (CR) rate at the fourth week of induction therapy was 83.3% and 89.7% (P=0.637) , respectively, and the complete molecular remission (CMR) was 48.3%and 58.6% (P=0.363) , respectively, the difference was not statistically significant. The 2-year overall survival (OS) rate of first-generation and second-generation TKI group was 34.9% and 64.0% (χ(2)=4.743, P=0.029) , the 2-year relapse free survival (RFS) rate was 17.2% and 55.0% (χ(2)=8.801, P=0.003) , respectively. Multivariate analysis showed that complete molecular remission (HR=0.281, 95%CI 0.151-0.523, P<0.001) was independent favorable prognostic factor for overall survival (OS) , complete molecular remission (HR=0.209, 95%CI 0.112-0.390, P<0.001) and second-generation TKI (HR=0.318, 95%CI 0.158-0.641, P=0.001) were independent favorable prognostic factors for RFS.

Conclusion:

For TKI-based regimen of BCR-ABL positive ALL, second-generation TKI is superior to first-generation TKI in OS and RFS time.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Inibidores de Proteínas Quinases / Leucemia-Linfoma Linfoblástico de Células Precursoras Tipo de estudo: Observational_studies / Prognostic_studies Limite: Humans Idioma: Zh Revista: Zhonghua Xue Ye Xue Za Zhi Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Inibidores de Proteínas Quinases / Leucemia-Linfoma Linfoblástico de Células Precursoras Tipo de estudo: Observational_studies / Prognostic_studies Limite: Humans Idioma: Zh Revista: Zhonghua Xue Ye Xue Za Zhi Ano de publicação: 2019 Tipo de documento: Article