高三尖杉酯碱治疗慢性粒细胞性白血病的系统评价  

Efficacy of homoharringtonine for the treatment of chronic myelogenous leukemia

作　　者：田怀平[1] 王芳 陶荣[3] 杨萍[1] 张健[1] 

机构地区：[1]上海交通大学医学院附属新华医院药学部,上海200092 [2]天水市复退军人精神病疗养院,天水741000 [3]上海交通大学医学院附属新华医院血液内科,上海200092

出　　处：《世界临床药物》2015年第1期19-25,共7页World Clinical Drug

摘　　要：目的系统评价高三尖杉酯碱治疗慢性粒细胞性白血病(CML)的疗效和安全性。方法计算机检索Pub Med、The Cochrane Library、EMbase、VIP、Wan Fang Data、CBM和CNKI数据库,检索时限均为从建库至2014年7月,收集高三尖杉酯碱治疗CML的随机对照研究。由两位研究者按照纳入与排除标准,独立进行文献筛选、资料提取和评价纳入研究的方法学质量。采用Rev Man 5.2软件进行Meta分析。结果共纳入7项研究,涉及CML病例531例。Meta分析结果显示:高三尖杉酯碱组的完全血液学反应(CHR)率高于羟基脲或IFNα-2b组。主要细胞遗传学反应(MCyR)率,高三尖杉酯碱组高于羟基脲组;完全细胞遗传学反应(CCyR)率,两组相当;部分细胞遗传学反应(PCyR)率和轻微细胞遗传学反应(mCyR)率,高三尖杉酯碱组均高于羟基脲组。高三尖杉酯碱组急变率低于羟基脲组,4年预期生存率高于羟基脲组。高三尖杉酯碱的药物不良反应较轻。结论高三尖杉酯碱单药低剂量治疗慢性期CML短期和远期疗效均较好,可作为部分患者的治疗选择。Objective To assess the efficacy and the safety of homoharringtonine for chronic myelogenous leukemia（CML） through literatures. Methods Databases such as Pub Med, The Cochrane Library, EMbase, VIP, Wan Fang Data, CBM and CNKI which were related to the clinical trials of homoharringtonine for CML were electronically searched. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Meta-analysis was performed by Rev Man 5.2. Results Seven literatures including 531 patients were involved. The results of meta-analysis showed that the homoharringtonine group was superior to the hydroxyl urea group or the IFNα-2b group in terms of CHR rate, MCy R rate, PCy R rate, m Cy R rate, blast rate and four years survival rate. There was no statistical difference in CCy R between the homoharringtonine group and the hydroxy urea group. Homoharringtonine caused less adverse reaction. Conclusion Low dose homoharringtonine alone shows considerable short term and long term efficacy in the treatment of late phase CML.

关 键 词：慢性粒细胞性白血病 高三尖杉酯碱 系统评价 META分析 

分 类 号：R557[医药卫生—血液循环系统疾病] R973[医药卫生—内科学]