中文摘要：

目的探讨采用伊马替尼（IM）联合化疗后第1次完全缓解期（CR，）行异基因造血干细胞移植（allo—SCT）及IM维持治疗成人Ph阳性急性淋巴细胞白血病（Ph^＋ -ALL）的临床疗效及相关预后因素。方法2006年3月至2010年12月在我院淋巴肿瘤中心CR，期完成allo-SCT治疗的16例成人Ph^＋-ALL患者纳入研究。所有患者均以IM联合标准VDCP±L（长春新碱＋柔红霉素＋环磷酰胺＋泼尼松±左旋门冬酰胺酶）方案诱导治疗，缓解后则联合改良HyperCVAD／MA方案强化巩固治疗，并于CR。期行allo-SCT；部分患者移植后给予IM维持治疗。随访至2011年3月31日，分析患者临床基本特征、总生存（OS）率、无病生存（DFS）率、累积复发（RI）率及非复发死亡（NRM）率，并探讨与生存相关的预后因素。结果16例患者采用IM联合化疗在移植前均维持血液学缓解，其中10例达分子生物学缓解。移植后所有患者均成功植入。中位随访27．1（7．4～65．8）个月，14例患者存活，其中2例患者移植后复发经IM挽救均存活，2例非复发死亡。3年预期OS及DFS率分别为（85．9±9．3）％和（83．9±10．5）％，3年RI率及NRM率分别为（16．1±10．5）％和（14．1±9．3）％。生存分析未显示影响移植疗效的预后因素。结论IM联合化疗及Hyper·CVAD／MA强化治疗可显著提高Ph^＋-ALL患者的缓解率及缓解质量，使患者在CR1期行allo—SCT的可行性增高，allo—SCT前、后联合IM能减少复发，提高长期OS及DFS率，是治疗成人Ph^＋- ALL的有效手段。

英文摘要：

Objective To explore the efficacy of imatinib （IM）-based chemotherapy followed by allogeneic hematopoietic stem cell transplantation （allo-SCT） in first complete remission（ CR1 ） for adult Ph＋ acute lymphoblastic leukemia [ Ph^＋ -ALL]. Methods From March 2006 to December 2010, 16 adult Ph^＋- ALL were enrolled in the study. All patients received IM combined with standard VDCP ± L as induction therapy then intensive consolidation with modified Hyper-CVAD/MA regimen plus IM, and followed by allo-SCT in CR1. Some of them received IM maintenance therapy after allo-SCT. With the follow up to March 31, 2011, the clinical parameters, overall survival （OS）, disease free survival （DFS）, relapse incidence （RI）, non-relapse mortality （NRM） and prognostic factors were analyzed. Results All 16 patients achieved morphological complete remission （CR） , and 10 of them achieved molecular CR. After transplantation, all patients obtained successful engraftments. With a median follow-up of 27.1 （7.4 - 65.8） months, 14 patients were alive, 2 died from NRM, and 2 relapsed. The estimated OS and DFS at 3 year were （85.9 ± 9.3） % and （83.9 ± 10.5 ） %, and cumulative RI and NRM at 3 year were （ 16.1 ± 10.5 ） % and （ 14.1 ± 9.3 ） %, respectively. None prognostic factor was found on analysis. Conclusion IM combined with intensive chemotherapy significantly increased the CR rate and improved the quality of CR. which prepared the feasibilitv of a11o-SCT in CR1. IM therapy pre- and post-allo-SCT would be a promising strategy for adult Ph ＋ -ALL to decrease relapse and facilitates favorable 0S and DFS.