Efficacy Evaluation Of Glivec For Granulocytic Leukemia Patients: A 6-year Follow-up Of 66 Cases

Object: To evaluate the efficacy of Glivec mesylate (Glivec) in patients with Philadelphia chromosome-positive (Ph-positive) chronic granulocytic leukemia (CGL) . Methods: 66 patients with Ph-positive CGL were treated with Glivec 400mg or 600mg once daily. Results: With a median follow-up of 41.5 (range 4.0～167.0 ) months,in chronic phase cumulative complete hematological response (CHR) rate was 100%,major cytogenetic response (MCyR) rate 91.2% and complete cytogenetic response(CCyR) rate 85.3%. Among patients with CCyR,cumulative complete molecular response (CMR) rate 82.4%. In accelerated phase cumulative CHR rate was 90.0%,MCyR rate 50.0% and CCyR rate 40.0%. Among patients with CCyR,CMR rate 35.0%. In blasted phase cumulativeCHR rate was 66.7%,MCyR rate 16.7% and CCyR rate 0.0%. Among patients with CCyR,CMR rate 0.0%. So far,all patients with Ph- negative cell clonal evolution remained in CHR. Single factor analysis for MCyR or CCyR showed that HGB <100g/L(P=0.00 or P=0.001)before therapy and primitive cell high percentage(≥0.05) in marrow and blood(P=0.01 and P=0.002,P=0.007 and P=0.036) before therapy were risk factors for suboptimal responses. Multivariate factors analysis for MCyR or CCyR showed that interval time to using Glivec(MCyR,CCyR P=0.00,RR=2.879 and P=0.00,RR=3.265),HGB <100g/L(MCyR,CCyR P=0.007,RR=0.146 and P=0.012,RR=0.199)and peripheral basophils≥0.05(MCyR,CCyR P=0.022,RR=0.257 and P=0.017,RR=0.151) were risk factors for independent suboptimal responses. Conclusions:Glivec significantly improves cytogenetic and molecular response rate and quality of life for patients with Ph- positive CGL.