Prophylactic administration of imatinib after hematopoietic cell transplantation for high-risk Philadelphia chromosome-positive leukemia
Prophylactic administration of imatinib after hematopoietic cell transplantation for high-risk Philadelphia chromosome-positive leukemia
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DOI：
10.1182/blood-2006-04-019836
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发表时间：
2007-04-01
期刊：
影响因子：
20.3
通讯作者：
Radich, Jerald P.
中科院分区：
文献类型：
--
作者：
Carpenter, Paul A.;Snyder, David S.;Radich, Jerald P.
异基因造血细胞移植(HCT)治疗高危Ph+白血病后经常复发。HCT后早期应用伊马替尼可能是预防复发Ph+白血病的有效方法，但这种方法的可行性尚未得到系统的验证。22例患者，其中15例为Ph+急性淋巴细胞白血病，7例为高危慢性粒细胞白血病，纳入前瞻性研究，从植入时起至HCT后365天内给予伊马替尼治疗。90天前，成人(n=19)的平均日耐受量为400 mg/d(200-500 mg/d)，儿童(n=3)的耐受量为265 mg/m(2)/d(200-290 mg/m(2)/d)。与服用伊马替尼相关的最常见的不良反应是1-3级恶心、呕吐和血清转氨酶升高。我们得出结论，伊马替尼可以在清髓性异基因红细胞移植后早期安全地使用，剂量强度与初级治疗中使用的剂量强度相当。
Relapse occurs frequently after allogeneic hematopoietic cell transplantation (HCT) for treatment of high-risk Philadelphia chromosome-positive (Ph+) leukemia. Administration of imatinib early after HCT might provide an effective approach for preventing recurrent Ph+ leukemia, but the feasibility of this approach has not been systematically tested. Twentytwo patients, 15 with Ph+ acute lympho- blastic leukemia and 7 with high-risk chronic myelogenous leukemia, were enrolled in a prospective study and given imatinib from the time of engraftment until 365 days after HCT. Before day 90, adults (n = 19) tolerated a median average daily imatinib dose of 400 mg/d (range, 200-500 mg/d), and children (n = 3) tolerated 265 mg/m(2)/d (range, 200-290 mg/m(2)/d). The most common adverse events related to imatinib administration were grade 1-3 nausea, emesis, and serum transaminase elevations. We conclude that imatinib can be safely administered early after myeloablative allogeneic HCT at a dose intensity comparable to that used in primary therapy.