伊马替尼治疗儿童Ph阳性急性淋巴细胞白血病的疗效和安全性  

Efficacy and safety of imatinib for the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia in children

作　　者：郭晔[1] 刘天峰[1] 阮敏[1] 杨文钰[1] 陈晓娟[1] 张丽[1] 王书春[1] 刘芳[1] 张家源[1] 刘晓明[1] 戚本泉[1] 邹尧[1] 竺晓凡[1] 

机构地区：[1]中国医学科学院北京协和医学院血液学研究所血液病医院儿童血液病诊疗中心,天津300020

出　　处：《中国当代儿科杂志》2015年第8期819-824,共6页Chinese Journal of Contemporary Pediatrics

基　　金：国家科技支撑计划课题(2007BAI04B03);天津市科技计划项目(12ZCDZSY18100);国家科技重大专项子课题重大新药创制(2011ZX09302-007)

摘　　要：目的研究GGLG-08方案联合络氨酸激酶抑制剂(TKI)—伊马替尼治疗儿童Ph阳性急性淋巴细胞白血病(Ph+ALL)的疗效及安全性。方法回顾性分析2008年10月至2013年12月初诊年龄<15岁的53例Ph+ALL患儿的临床资料,给予患儿CCLG-ALL2008(高危组HR)方案化疗(HR组,26例)或伊马替尼联合CCLG-ALL2008(高危组HR)方案化疗(TKI+HR组,27例),比较两组的疗效及不良反应。结果 TKI+HR组诱导治疗后完全缓解(CR)率为100%,诱导期相关病死率为0;HR组CR率为75%,诱导相关病死率为15%;HR组3年无事件生存率(EFS)为(6±5)%;TKI+HR组5年EFS为(52±11)%。与HR组比较,TKI+HR组未增加化疗相关毒性,诱导期感染发生率反而下降。结论伊马替尼的应用使儿童Ph+ALL的临床疗效获得明显改善,同时具有良好的安全性。Objective To study the efficacy and safety of Chinese Childhood Leukemia Group ALL 2008（CCLG-ALL2008） protocol combined with tyrosine kinase inhibitor（TKI, imatinib） for the treatment of Philadelphia chromosome-positive（Ph＋） acute lymphoblastic leukemia（ALL） in children. Methods The clinical data of 53 patients aged less than 15 years when first diagnosed with Ph＋ ALL between October 2008 and December 2013 were retrospectively analyzed. The patients were assigned to two groups： HR（n=26） and HR＋TKI（n=27）. The HR group was treated with CCLG-ALL2008 protocol（for high-risk patients）. The HR＋TKI group was treated with imatinib in combination with CCLG-ALL2008 protocol（for high-risk patients）. Results The complete remission rate and chemotherapy induction-related mortality rate in the TKI＋HR and HR groups were 100% vs 75% and 0 vs 15%, respectively. The 3-year event-free survival（EFS） rate in the HR group was（6±5）%; the 5-year EFS rate of the TKI＋HR group was（52±11）%. Compared with the HR group, the TKI＋HR group had no increase in the toxic responses to chemotherapy and had a decrease in the infection rate during the induction period. Conclusions Application of imatinib significantly improves the clinical efficacy in children with Ph＋ ALL and has good safety.

关 键 词：伊马替尼 PH染色体 急性淋巴细胞白血病 儿童 

分 类 号：R733.71[医药卫生—肿瘤]