As_2O_3联合格列卫对难治性慢性粒细胞白血病的靶向治疗  

The Clinic Study of Targeted Therapy in the Refractory Chronic Myelocytic Leukemia by As_2O_3 Combined with Imatinib Mesylate

作　　者：沈云峰[1] 杨国华[1] 朱华淳[1] 蒋元强[1] 周新[1] 孙鸿丽[1] 庄芸[1] 孙超[1] 毛玉文[1] 张日[2] 

机构地区：[1]南京医科大学附属无锡第一医院血液科,江苏无锡214002 [2]苏州大学医学院附属一院血液科,江苏苏州215006

出　　处：《江南大学学报（自然科学版）》2005年第6期649-652,共4页Joural of Jiangnan University (Natural Science Edition)　

基　　金：江苏省卫生厅医学科技发展基金(H200206)资助课题

摘　　要：目的通过As2O3联合格列卫对Bac/Abl的作用靶点及二者药物作用无交叉耐药性的机制,达到使两种药发挥协同作用,更有效地治疗难治性慢性粒细胞白血病的目的.方法使用格列卫200～400 mg/d,加As2O310 mg/次,7～10 d/月作为一个周期,共用2～3个周期以评价疗效.结果 9例均为单用格列卫无效的患者,经联合使用后有3例达到血液学缓解,3例达到部分缓解,3例未缓解或恶化;9例均未达到细胞遗传学及分子生物学的缓解.结论对格列卫耐药的难治性慢性粒细胞白血病患者,继续联合应用As2O3,可以使部分患者达到缓解或部分缓解,二者无交叉耐药性并具有良好的协同作用.OBJECTIVE To study the effectiveness of arsenic trioxide （As2O3） combined with Imatinib mesylate in refractory chronic myelocytic leukemia, because Imatinib and As2O3 have different effective target and have no across tolerance. METHOD Nine patients were treated with Imatinib 200～400 mg per day and As2O3 10 mg on day 1～ 10, one month as a cycle. We evaluated the effectiveness after 2～3 cycles. RESULT All patients who haven＇t effect with Imatinib mesylate alone were treated with above regimen, there were 3 complete remission（CR）, 3 partial remission（PR） and 3 non-responders（NR） or aggravation. But all nine patients had no respond in the aspect of cytogenetic and molecular biology. CONCLUSION Combined treatment of Imatinib mesylate with As2O3 may result in complete or partial remission in some patients who resistant to Imatinib alone. They have synergistic action but no across tolerance.

关 键 词：慢性粒细胞性白血病 三氧化二砷 格列卫 靶向治疗 

分 类 号：R557.3[医药卫生—血液循环系统疾病]