酪氨酸激酶抑制剂联合化疗治疗Ph阳性急性淋巴细胞白血病的临床观察  

Clinical Observation of Tyrosine Kinase Inhibitor Combined with Chemotherapy in the Treatment of Ph Positive Acute Lymphatic Leukemia

作　　者：苗真 甘思林[1] 邢海洲[1] 刘延方[1] 谢新生[1] 程远东[1] 孙玲[1] 万鼎铭[1] 孙慧[1] 

机构地区：[1]郑州大学第一附属医院血液科,河南郑州450052

出　　处：《肿瘤基础与临床》2014年第2期119-121,共3页journal of basic and clinical oncology

摘　　要：目的观察酪氨酸激酶抑制剂联合化疗治疗Ph阳性急性淋巴细胞白血病的疗效及毒副反应。方法回顾性分析41例成人初治Ph阳性急性淋巴细胞白血病的治疗资料,比较观察应用酪氨酸激酶抑制剂联合化疗方案的联合组(21例)及单纯应用化疗方案的单纯化疗组(20例)的缓解率、缓解持续时间、中位生存期、生存率、粒细胞缺乏时间、出血率、感染率等指标。结果联合组和单纯化疗组的诱导缓解率分别为85.7%和55.0%(P=0.030);平均缓解时间分别为10.3个月和6.5个月(P=0.020);联合组和单纯化疗组的中位生存期分别为12.0个月和10.0个月,累积半年生存率分别为95.2%和75.0%,1 a生存率分别47.6%和20.0%(P=0.009)。2组均出现Ⅳ度骨髓抑制,2组化疗后中性粒细胞缺乏持续时间比较差异均无统计学意义(P=0.196);2组继发出血率52.4%和45.0%(P=0.880)、感染率61.9%和55.0%(P=0.650)等非血液学毒性发生率差异均无统计学意义。结论酪氨酸激酶抑制剂联合化疗能够更好地缓解Ph阳性急性淋巴细胞白血病患者病情,延长患者生存期,且毒副反应未见明显增加。Objective To investigate the curative effect and toxicities of tyrosine kinase inhibitor combined with chemotherapy in the treatment of Ph positive acute lymphoblastic leukemia. Methods The treatment data of the 41 cases of adult with Ph positive acute lymphoblastic leukemia were analyzed retrospectively. Twenty-one cases were treated by tyrosine kinase inhibitors combined with chemotherapy,twenty cases were treated by the single chemother-apy. The response rate,relieve duration,median survival,survival rate,granulocyte lack time,bleeding rate,infection rate and other indicators were compared between the two groups. Results The induced remission rate was 85. 7%in the combination group,and was 55. 0% in the pure chemotherapy group（P = 0. 030）. The average alleviate time were 10. 3 months and 6. 5 months respectively（P = 0. 020）. The median survival time were 12. 0 months and 10. 0 months respectively,the cumulative half year survival rate were 95. 2% and 75. 0% respectively,and 1-year survival rates were 47. 6% and 20. 0% respectively（P = 0. 009）. bone marrow suppression with grade Ⅳ was observed in the two groups,neutrophils lack duration had no statistical difference between the two groups after chemotherapy（P= 0. 196）. The secondary hemorrhage rate of the two groups were 52. 4% and 45. 0% respectively（P = 0. 880）, the infection rates were 61. 9% and 55. 0% respectively（P = 0. 650）. Conclusion Tyrosine kinase inhibitor com-bined with chemotherapy can significantly improve the response rate of Ph positive acute lymphoblastic leukemia,＆amp;nbsp;improve the survival,and the toxicities can be tolerated.

关 键 词：PH染色体 急性淋巴细胞白血病 酪氨酸激酶抑制剂 

分 类 号：R733.7[医药卫生—肿瘤] R730.58[医药卫生—临床医学]