伊马替尼联合Hyper-CVAD方案治疗Ph染色体阳性急性淋巴白血病的临床观察  

Application of imatinib plus Hyper-CVAD chemotherapy regimen in patients with Ph chromosome positive acute lymphocytic leukemia

作　　者：郭智[1] 陈惠仁[1] 刘晓东[1] 杨凯[1] 陈鹏[1] 刘兵[1] 刘丹[1] 王丙然[1] 姚雨石[1] 何学鹏[1] 

机构地区：[1]北京军区总医院血液科,100700

出　　处：《中华医学杂志》2011年第20期1384-1387,共4页National Medical Journal of China

摘　　要：目的 观察伊马替尼联合Hyper-CVAD（环磷酰胺＋长春地辛＋吡柔比星＋地塞米松或甲氨蝶呤＋阿糖胞苷）方案治疗Ph染色体阳性急性淋巴白血病（Ph^＋ALL）患者的疗效及安全性.方法 北京军区总医院血液科2005年1月至2010年1月应用伊马替尼联合Hyper-CVAD方案治疗18例Ph＋ALL患者,治疗方案为伊马替尼、Hyper-CVAD（A/B方案）序贯治疗,持续8个疗程,维持2年;同期18例Ph^＋ALL患者行造血干细胞移植设为对照组.结果 治疗组18例患者平均年龄33.1岁,诱导化疗获得总缓解率为100%,中位生存期为28.8（8.0～60.0）个月,1、2、3年总生存率分别为77.8%、72.2%、66.7%;对照组诱导化疗获得总缓解率为100%,中位生存期为22.5（4.0～58.0）个月,1、2、3年总生存率分别为66.7%、55.6%、50.O%,随访至2010年10月治疗组复发死亡5例,复发相关病死率为27.8%;对照组复发死亡4例,复发相关病死率为22.2%;总计治疗组死亡6例,病死率为33.3%,对照组死亡9例,病死率为50.0%.结论 伊马替尼联合Hyper-CVAD方案治疗Ph^＋ALL患者的生存率明显提高,中位缓解时间及生存时间超过异基因造血干细胞移植水平.Objective To report the efficacy and safety of imatinib plus Hyper-CVAD chemotherapy regimen in the treatment of patients with ph chmmosome positive acute lymphocytic leukemia（Ph＋ALL）.Methods A sequential 2-year and 8-cycle treatment of imatinib plus Hyper-CVAD（A/B program）was administrated in 18 Ph＋ALL patients treated at our hospital since January 2005 to January 2010.And another 18 Ph＋ALL patients undergoing no allogeneic hematopoietie stem cell transplantation were selected as controls.Resuits Among 18 patients on chemotherapy,their average age was 33.1 years, the total response rate 100%following induction chemotherapy and the median survival 28.8（8.0-60.0）months.patients,the response rate following induction chemotherapy was 100%and the median survival 22.5（4.0-58.0）months.And the 1-,2-and 3-year overall survival rates were 66.7%.55.6%and 50.0%respectively.A recent follow-up showed that 5 patients（27.8%）died from relapse in the chemotherapy group and 4（22.2%）in the control group.The overall deaths were 6（33.3%）in the chemotherapy group and 9（50.0%）in the control group.Conclusions Imatinib plus Hyper-CVAD chemotherapy regimen is associated with significantly improved survival rates. Superior to allogeneie hematopoietic stem cell transplantation,it offers a prolonged median response time and survival time in Ph＋ALL patients.

关 键 词：白血病 淋巴细胞 急性 费城染色体 伊马替尼 Hyper-CVAD方案 生存率 

分 类 号：R733.71[医药卫生—肿瘤]