伊马替尼联合干扰素治疗慢性髓性白血病慢性期疗效的Meta分析  

Meta-analysis of imatinib mesylate with or without interferon for chronic-phase chronic myeloid leukemia

作　　者：李梦琪[1] 张鸣[1] 廖爱军[1] 刘卓刚[1] 

机构地区：[1]中国医科大学附属盛京医院,沈阳110022

出　　处：《中华血液学杂志》2013年第8期685-690,共6页Chinese Journal of Hematology

摘　　要：目的比较伊马替尼（IM）单药及与干扰素联合治疗慢性髓性自血病慢性期（CML-CP）的疗效。方法计算机检索PubMed数据库、Cochran图书馆的临床对照试验数据库CENTRAL、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（cBM）、万方数据库、维普数据库，并进一步对纳入文献的参考文献进行扩大检索。纳入的随机对照试验依据Cochran风险偏倚评估工具进行质量评价。采用RevMan5．1软件进行统计分析。结果共纳入5篇文献，CML．CP患者1754例。Meta分析结果显示：干扰素与IM联合组与IM单药治疗组之间的12个月时完全细胞遗传学反应（CCyR）率差异无统计学意义，但联合用药可以提高12个月时的主要分子学反应（MMR）率（OR=1．57，95％CI：1．2以1．96，P=0．02），其中亚组分析提示长效干扰素联合IM依然存在此作用（OR=2．43，95％CI：1．78-3．33，P〈0．01）。结论IM与干扰素联合用药对于CML-CP患者12个月时的CCyR并无影响，但可以提高MMR。Objective Meta-analysis of the efficiencies of imatinib mesylate （IM） with or with- out interferon for chronic myeloid leukemia-chronic phase （CML-CP） patients. Methods Published studies of IM with or without interferon for CML-CP patients as first-line therapy were collected from PubMed, Cochrane Central Register of Controlled Trials （CENTRAL） of the Cochrane Library, China National Knowledge Infrastructure （CNKI）, China Biology Medicine （CBM）, VIP information and WANFANG database. References of retrieved articles were also identified. The quality of each randomized controlled trial （RCT） was evaluated by the Cochrane collaboration＇ s tool for assessing the risk of bias. Data analysis was performed with RevMan 5.1. Results A total of 5 articles involving 1754 patients were included. Meta-analysis results showed that there were no statistical differences between IM with interferon and IM monotherapy for the complete cytogenetic response （CCyR） rate at 12 months, but IM with interferon could improve major molecular response （MMR） rate at 12 months （OR=1.57, 95% CI： 1.26- 1.96, P=- 0.02）. Furthermore, IM combined with pegylated-interferon demonstrated superiority for MMR at 12 months （OR=2.43, 95% CI： 1.78-3.33, P〈0.01）. Conclusion Combination of IM and interferon does not increase CCyR rate, but improve MMR rate at 12 months.

关 键 词：伊马替尼 干扰素 白血病 髓样 慢性期 META分析 

分 类 号：R733.72[医药卫生—肿瘤]