摘要
目的：观察伊马替尼治疗慢性粒细胞白血病（CML）的临床效果及安全性。方法慢性期（CML-CP）患者IM中位剂量为400 mg/d，加速期（CML-AP）患者中位剂量为600 mg/d，对于急变期（CML-BP）患者采用IM＋HAG联合治疗方案即IM 600 mg/d联合高三尖杉酯碱2 mg/d，阿糖胞苷25 mg，1次/12 h，粒细胞集落刺激因子200μg/m2。治疗过程中根据患者血常规和药物不良反应严重程度及时调整药物剂量或暂停用药。治疗初期每周复查血常规，治疗3个月后每月复查，治疗期间3~6个月复查髓细胞形态学、染色体核型及BCR-ABL融合基因。结果CML-CP患者治疗3、12个月后的完全血液学缓解率、完全细胞遗传学缓解率、主要细胞遗传学缓解率、完全分子学缓解率与CML-AP，CML-BP比较，差异有统计学意义（P〈0.05）。 CML-CP患者1、2、4年疾病无进展生存率及总体生存率与CML-AP、CML-BP比较差异有统计学意义（P〈0.05）。结论 IM治疗CML具有较好的效果及安全性，特别对于CML-CP患者的治疗可获得较高的细胞遗传学与分子学缓解，总体生存期得到延长，而对于CML-AP、CML-BP患者的治疗远期疗效不甚理想。
Objective To observe clinical effect and safety of imatinib （IM）in the treatment of chronic myelocytic leukemia （CML）. Methods IM median dose of CML chronic phase （CML-CP）patient was 400 mg/d.IM median dose of CML accelerated phase（CML-AP）patientwas 600 mg/d.IM＋HAG combination therapy scheme including IM（600 mg/d）, homoharringtonine（2 mg/d）,cytarabine （25 mg,1once/12 h）,granulocyte colony stimulating factor（200 g/m2） were used in CML blastic phase（CML-BP）.The drug dose was adjusted timely and suspend medication was implemented according to the patient’s blood routine test and the severity of drug adverse reaction in the process of treatment.Blood routine test was reviewed weekly in early treatment,after treatment of 3 months,blood routine test was reviewed monthly,marrow cell morphology,chromosome karyotype and BCR-ABL fusion gene were reviewed from 3 to 6 months in the process of treatment. Results After treatment of 3,12 months,CHR rate,CCyR rate,MCyR rate and CMoR rate of CML-CP patient compared with CML-AP patient and CML-BP patient,with statistical difference （P〈0.05）.1,2,4-year disease progression free survival rate and overall survival rate of CML-CP patient compared with CML-AP patient and CML-BP patient, with statistical difference（P〈0.05）. Conclusion IM in the treatment of CML has good curative effect and safety,especial-ly for the treatment of patient with CML-CP can obtain higher cell genetics and molecular biology,the overall survival is extended,and for the treatment of patients with CML-AP,the CML-BP forward curative effect is not very ideal.
出处
《中国当代医药》
2014年第24期105-107,共3页
China Modern Medicine
关键词
慢性粒细胞白血病
伊马替尼
慢性期
加速期
急变期
疗效
Chronic myelocytic leukemia Imatinib Chronic phase Accelerated phase Blastic phase Curative effect
