Prolonged Survival with Imatinib Mesylate Combined with Chemotherapy and Allogeneic Stem Cell Transplantation in de novo Ph+ Acute Myeloid LeukemiaSun J. · Wang Z. · Luo Y. · Tan Y. · Allan D.S. · Huang H.
aDepartment of Hematology, Bone Marrow Transplant Center, First Affiliated Hospital, College of Medicine, Zhejiang University, bThe Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China; cDivision of Hematology, The Ottawa Hospital, General Site, Ottawa, Ont., Canada
Background: De novo Philadelphia chromosome-positive (Ph+) acute myeloid leukemia (AML) is a rare disease with a poor prognosis. Imatinib mesylate (IM) is the standard treatment for Ph+ chronic myeloid leukemia and Ph+ acute lymphoblastic leukemia; however, its role in Ph+ AML has not been extensively investigated. Methods: Two patients aged of 46 and 19 years were diagnosed with de novo Ph+ AML according to the WHO Classification of Myeloid Neoplasms (2002) and the French-American-British (FAB) classification systems (1989). Cytogenetic analysis confirmed the presence of t(9;22). Standard RT-PCR was used to detect expression of the BCR-ABL1 fusion gene. Minimal residual disease was monitored by RQ-PCR for the BCR-ABL1/ABL ratio. Both patients received initial IM therapy combined with daunorubicin-based chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) and IM maintenance treatment after allo-HSCT. Results: Both patients achieved long-term disease-free survival with complete hematologic response, complete molecular response, and complete cytogenetic response for 44 and 48 months, respectively. Conclusions: Our cases indicate that IM combined with daunorubicin-based chemotherapy followed by allo-HSCT and IM maintenance treatment is associated with a favorable outcome for de novo Ph+ AML, especially when IM is used in an early phase of AML.
He Huang, MD, PhD
The First Affiliated Hospital, School of Medicine, Zhejiang University
No. 79 Qingchun Road
Hangzhou, 310003, Zhejiang (China)
Tel. +86 571 8723 6706, E-Mail firstname.lastname@example.org
Jie Sun and Zhen Wang are co-first authors.
Received: June 15, 2011
Accepted after revision: October 3, 2011
Published online: January 12, 2012
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 2, Number of References : 16
Vol. 127, No. 3, Year 2012 (Cover Date: March 2012)
Journal Editor: Ben-Bassat I. (Qiryat-Ono)
ISSN: 0001-5792 (Print), eISSN: 1421-9662 (Online)
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