The Case-control Study Of Adult Ph-positive Acute Leukemia Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Objective: To investigate the different effect on treatment of adult Ph-positive acute leukemia(Ph+AL)between allogeneic hematopoietic stem cell transplantation(allo-HSCT)and chemotherapy+TKIs and evaluate the prognostic factors of allo-HSCT.Methods:Retrospectively analyzed effect between 20 patients with Ph+AL(transplantation group)who underwent allo-HSCT and 42 patients with Ph+AL(control group)who accepted conventional chemotherapy including Tyrosine kinase inhibitor(TKIs)in the Department of Hematology,all patients were enrolled in Second Hospital of Hebei Medical University from November2012 to September 2017.1-year overall survival(OS),disease-free survival(DFS)and cumulative relapse rate(RR)were estimated by Kaplan-Meier survival analysis in SPSS 21.0.The negative prognostic factors of allo-HSCT were also statistically examined by COX regression analysis.Results:There was no difference in age and gender between the transplantation group and the control group(P>0.05).The estimated OS,DFS and RR in 1year were 73.7%±10.2% vs 51.5%±8.1%,P=0.043;69.0%±11.5% vs36.7%±7.7%,P=0.004;13.8%±9.1% vs 36.5%±9.4%,P=0.254 in the transplantation group and the control group respectively.The median relapse time between the transplant group and the control group was 9.45(0.8-63.1)months and 7.08(0.43-62.9)months,P=0.157,respectively.Univariate analysis revealed that the hepatic veno-occlusive disease(HVOD)was a risk factor of poor prognosis for the allo-HSCT recipients,P=0.014.Conclusion:We suggest that allo-HSCT improves OS and DFS in patients with Ph+AL compared to chemotherapy+TKIs,though the RR of allo-HSCT was not significantly different from that of chemotherapy+TKIs,interestingly,HVOD is a risk factor of poor prognosis for the allo-HSCT recipients.