摘要
目的:评估伊马替尼联合化疗方案治疗成人Ph染色体阳性急性淋巴细胞白血病(Ph+ALL)的疗效。方法:回顾性分析76例初治成人Ph+ALL的病例资料,通过比较应用伊马替尼联合化疗方案的联合组(56例)及单纯化疗组(20例)的完全缓解率、复发率、总生存(OS)时间、无病生存(DFS)时间等指标,评估伊马替尼联合化疗治疗成人Ph+ALL的疗效。结果:联合组和单纯化疗组的诱导完全缓解率分别为85.7%(48/56)和45.0%(9/20),2组差异有统计学意义(P<0.05)。联合组和单纯化疗组的血液学缓解持续时间分别为(6.8±5.6)个月和(5.7±4.5)个月,复发率分别为60.7%(34/56)和85.0%(17/20),2组差异无统计学意义。联合组和单纯化疗组的中位OS分别为12(2~39)个月和4.5(0~17)个月,1年、2年OS率分别为50.0%、18.0%和10.0%、0,2组差异有统计学意义(P<0.05)。联合组和单纯化疗组的中位DFS分别为7(0~35)个月和3(1~13)个月,1年、2年DFS率分别为31.6%、17.4%和11.6%、0,2组差异无统计学意义。联合组和单纯化疗组的常见不良反应为骨髓抑制、感染、出血、胃肠道反应、肝功能损害、乏力,2组不良反应差异无统计学意义。结论:在成人Ph+ALL患者治疗中,采用伊马替尼联合化疗方案,可以提高完全缓解率及改善预后,并且不增加治疗相关毒副反应。
Objective：To evaluate the efficacy of imatinib in combination with chemotherapy in the treatment of Philadelphia chromosome positive adult acute lymphoblastic leukemia（Ph＋ALL）.Method：The clinical data of 76 cases of de novo adult patients with Ph＋ALL were retrospectively analyzed.Fifty-six patients were treated with imatinib combined with chemotherapy and 20 patients were treated with chemotherapy alone.The complete remission rate,relapse rate,overall survival（OS）and disease-free survival（DFS）were analyzed.Result：The complete remission rate of combination group was higher than that of chemotherapy alone group（85.7% vs.45.0%,P〈0.05）.The cumulative relapse rate of combination group was lower than that of chemotherapy alone group（60.7% vs.85.0%,P〈0.05）.The average durations of complete remission were 6.8months and 5.7months respectively.The median OS of combination group was significantly longer than that of chemotherapy alone group（12months vs.4.5months,P〈0.05）.The cumulative 1-year OS were 50.0% and 10.0%,while 2-year OS were18.0% and 0（P〈0.05）,respectively.No significant difference was found between the two groups in median DFS（7months vs.3 months,P〉0.05）,and the cumulative 1-year DFS were 31.6% and 11.6%,while 2-year DFS were 17.4% and 0 respectively（P〉0.05）.The major adverse events of combination group and chemotherapy alone group during treatment were hematologic toxicities,infection,hemorrhage,gastrointestnal symptoms,hepatic damage and fatigue.The adverse events had no difference between the two groups.Conclusion：Imatinib in combination with chemotherapy has significantly improved the complete remission rate and survival in adults with Ph＋ALL,and has not increased related adverse events.
作者
蔡如玉
郑晓云
郑静
陈鑫基
郑志宏
陈步远
刘庭波
胡建达
CAI Ruyu ZHENG Xiaoyun ZHENG Jing CHEN Xinji ZHENG Zhihong CHEN Buyuan LIU Tingbo HU Jianda(Fujian Institute of Hematology, Union Hospital of Fujian Medical University, Fujian Provincial Key Laboratory on Hematology, Fuzhou, 350001, China)
出处
《临床血液学杂志》
CAS
2017年第1期47-50,共4页
Journal of Clinical Hematology
基金
国家和福建省临床重点专科建设项目(No:201130301、2012149)
