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目的:探讨B cr/ab l阳性成人急性淋巴细胞白血病(ALL)的治疗。方法:10例成人ALL经骨髓细胞形态学、细胞化学、免疫学分型、融合基因检查确诊为B cr/ab l阳性B细胞ALL。化疗不缓解者改用格列卫(400 m g/d)治疗。5例缓解后行异基因造血干细胞移植,5例行巩固强化治疗。结果:常规化疗使6例患者达到完全缓解(60%);4例未缓解者,用格列卫治疗均达到CR。5例接受移植患者2例复发,移植患者与接受巩固强化治疗的患者中位缓解期分别为12个月与8个月(P<0.01);中位生存期为18个月与10个月(P<0.05)。结论:B cr/ab l融合基因阳性成人ALL化疗缓解率较低,格列卫治疗显著提高缓解率,与单纯化疗相比,异基因造血干细胞移植使患者生存期明显延长。
Objective: To investigate the treatment of B cr / ab l positive adult acute lymphoblastic leukemia (ALL). Methods: Ten cases of adult ALL were diagnosed as B cr / ab l positive B cell ALL by morphology, cytochemistry, immunological typing and fusion gene examination. Chemotherapy without remission to Gleevec (400 m g / d) treatment. Five patients were treated with allogeneic hematopoietic stem cell transplantation and 5 patients underwent intensive consolidation therapy. Results: 6 cases achieved complete remission (60%) with conventional chemotherapy. In 4 cases without remission, CR was achieved with treatment with Gleevec. The median response time was 18 months and 10 months (median, 12 months and 8 months, respectively) in 5 patients who underwent transplantation and in 2 patients who underwent transplantation and consolidation. P <0.05). Conclusion: The response rate of B cr / ab 1 fusion gene-positive adult ALL is low, and the treatment with Gleevec significantly improves the remission rate. Compared with chemotherapy alone, allogeneic hematopoietic stem cell transplantation significantly prolongs the survival of patients.