| 王良妥,张湘兰,司徒健瑜,等.甲磺酸伊马替尼对慢性髓系白血病患者效果的相关因素研究[J].安徽医药,2016,20(1):171-174. |
| 甲磺酸伊马替尼对慢性髓系白血病患者效果的相关因素研究 |
| Analysis of related factors in 70 chronic myeloid leukemia patients treated with imatinib mesylate |
| 投稿时间：2015-07-08 |
| DOI： |
| 中文关键词: 甲磺酸伊马替尼 慢性髓系白血病 相关因素 |
| 英文关键词: chronic myelogenous leukemia imatinib mesylate related factors |
| 基金项目: |
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| 中文摘要: |
| 目的 研究甲磺酸伊马替尼对慢性髓系白血病(CML)患者效果的相关因素。方法 2010年1月至2015年3月,该院接收70例慢性髓系白血病患者口服甲磺酸伊马替尼400~600 mg·d-1,其中慢性期患者(CP)55例(ECP30例,LCP25例),加速期(AP)15例,急变期(BC)9例。检测完全血液学反应(CHR)、完全细胞遗传学反应(CCyR)、主要细胞遗传学反应(MCyR)和完全分子学反应(CMoR)等指标,分析甲磺酸伊马替尼对慢性髓系白血病患者效果的相关因素。结果 截至2015年3月,该院70例CML患者均能耐受伊马替尼。(1)70例CML患者中,初治组的CHR、CCyR、MCyR和CMoR分别为100%、71.9%、80.8%和74.9%,复治组分别为100%、45.8%、79.1%和53.9%,差异无统计学意义。(2)低危组的CHR、CCyR、MCyR和CMoR分别为100%、63.7%、78.9% 和56.3%；中危组分别为100%、76.1%、79.6%和47.9%；高危组分别为100%、49.8%、76.3%和46.8%,差异无统计学意义。(3)单因素分析表明,治疗前WBC数、Hb水平和外周血嗜碱粒细胞比率预示患者易于达到CHR、CCyR、MCyR或CMoR独立的有利因素,P值分别为0.032,0.024和0.0016。(4)CP(ECP30例,LCP25例):中位追踪为15个月,Logistic回归分析表明,患者获得的完全血液学反应(CHR)率为90.9%,完全细胞遗传学反应(CCyR)率为85.5%,主要细胞遗传学反应(MCyR)率为69.1%和完全分子学反应(CMoR)率为63.6%。其中ECP反应率分别为90%、83.3%、66.7%和63.3%；LCP反应率分别为92%、88%、72%和64%。AP和BC:中位追踪为15个月,获得的CHR、CCyR、MCyR和CMoR分别为55%、45%、30%和20%。结论 伊马替尼可以使CML患者获得较高的CHR、CCyR、MCyR和CMoR。无论对于初治患者还是复治患者,伊马替尼均可以作为CML的首选分子靶向药物。 |
| 英文摘要: |
| Objective The aim of this study was to investigate the related factors of imatinib mesylate on myeloid leukemia patients. Methods 70 CML patients received imatinib mesylate at a dose of 400～600 mg orally per day and we evaluated their complete hematologic response (CHR), complete cytogenetic response (CCyR), major cytogenetic response (MCyR) and complete molecular response (CMoR), etc.in patients of chronic phase (CP) (early chronic phase and chronic phase), accelerated phase (AP) and blast crisis (BC). And then analyzed the related factors of imatinib mesylate on chronic myeloid leukemia. Results Until the February 2015 in our hospital, 55 cases of the 70 chronic myeloid leukemia patients are in chronic phase (CP) (30 cases of early chronic phase, 25 cases of late chronic phase); 11 cases are in accelerated phase (AP); 9 cases are in blast crisis (BC). (1)After a median follow up of 15 months, all the 70 cases of CML patients reached a 100% CHR. Among primary treated group, the CHR rate was 100%, CCyR rate 80.8%, MCyR rate 71.9% and CMoR 74.9%. And in retreated group, the CHR rate, CCyR, MCyR and CMoR were 100%, 45.8%, 79.1% and 53.9%, respectively, and there was no significant difference. (2)The CHR rate, CCyR, MCyR and CMoR in low-risk CML patients were 100%, 63.7%, 78.9% and 56.3%, respectively. The rates in intermediate risk CML patients were 100%, 76.1%, 79.6% and 47.9%, respectively. The rates in high-risk CML patients were 100%, 49.8%, 76.3% and 46.8%, respectively and there was no significant difference. (3)Before treatment, the WBC count was less than 100×109·L-1, the Hb level was much more than 130 g·L-1, and the rate of basophil count in peripheral blood was less than 0.05. This indicated that CML patients were susceptible to the beneficial rates of CHR, CCyR, MCyR or CMoR. (4)Chronic phase (30 patients of early chronic phase, 30 cases of late chronic phase) with a median follow-up of 15 months, overall CHR rate was 90.9%, CCyR rate 85.5%, MCyR rate 69.1%, and CMoR rate 63.6%. Among the total response rates, early chronic phase (<12 months) were 90%, 83.3%, 66.7% and 63.3%, respectively; that of late chronic phase (≥12 months) were 92%, 88%, 72% and 64%, respectively. AP and BC:with a median follow-up of 15 months, the rates of CHR, CCyR, MCyR and CMoR were 55%, 45%, 30% and 20%, respectively (Table 4). Conclusions The CML patients in chronic phase treated with imatinib mesylate can achieve a better CHR, CCyR, MCyR and CMoR and it should be considered that the imatinib mesylate is a drug of the optimal molecular-targeted medicine for primary treated and retreated CML patients. |
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