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Leuk Lymphoma. 2016 Oct;57(10):2321-9. doi: 10.3109/10428194.2016.1144882. Epub 2016 Feb 16.

Sustaining integrating imatinib and interferon-α into maintenance therapy improves survival of patients with Philadelphia positive acute lymphoblastic leukemia ineligible for allogeneic stem cell transplantation.

Author information

1
a Department of Hematology, Hematologic Research Laboratory , West China Hospital of Sichuan University , Chengdu , PR China ;
2
b Department of Laboratory Medicine , West China Hospital of Sichuan University , Chengdu , PR China ;
3
c Department of Hematology , People's Hospital of Deyang , Deyang , PR China ;
4
d Department of Hematology , Central Hospital of Mianyang , Mianyang , PR China ;
5
e Department of Hematology , the 3rd People's Hospital of Chengdu , Chengdu , PR China ;
6
f Department of Hematology , the First Hospital of Liangshan , Xichang , PR China.

Abstract

We report the clinical results of sustainedly integrating imatinib and interferon-α into maintenance therapy in the patients ineligible for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Maintenance therapy lasted for 5 years with imatinib 400 mg daily, interferon-α 3 million units, 2∼3 doses per week, and chemotherapy including vindesine and dexamethasone scheduled monthly in first year, once every 2 months in second year, and once every 3 months in third year. The chemotherapy was discontinued after 3 years and the imatinib and interferon-α continued for another 2 years. For 41 patients without allo-HSCT with a median follow-up of 32 months, the 3-year DFS and OS were 42.7  ± 8.6% and 57.9  ± 8.4%, respectively. Our study suggests that sustaining maintenance with low-dose chemotherapy, imatinib and interferon-α improved survival of adult Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL) patients ineligible for allo-HSCT, and even provided an opportunity for cure. BCR/ABL persistent negativity at 6 and 9 months may have benefit to choose suitable patients for the imatinib/interferon-α maintenance strategy.

KEYWORDS:

Imatinib; Philadelphia chromosome positive acute lymphoblastic leukemia; interferon-α; long-term survival; maintenance therapy

PMID:
26879808
DOI:
10.3109/10428194.2016.1144882
[Indexed for MEDLINE]

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