格列卫治疗儿童Ph染色体阳性急性淋巴细胞白血病9例疗效观察  

Clinical Effects of Gleevec on 9 Cases of Philadelphia Chromosome-positive Acute Lymphoblastic Leukaemia in Children

作　　者：毛彦娜[1] 刘炜[1] 李彦格[1] 田亮[1] 宋丽丽[1] 

机构地区：[1]郑州市儿童医院,河南郑州450052

出　　处：《中国药物评价》2016年第3期153-154,164,共3页Chinese Journal of Drug Evaluation

摘　　要：目的:评价格列卫治疗儿童Ph染色体阳性急性淋巴细胞白血病Ph^+(acute lymphoblastic leukaemia,Ph^+ALL)的效果和不良反应。方法:收集我院血液肿瘤科2011年1月至2013年5月确诊的9例Ph^+ALL患儿,于诱导治疗后开始口服格列卫340 mg/m^2·d,30 d为1疗程,每次于饭后0.5 h口服,观察格列卫治疗后Ph^+ALL患者遗传学缓解率,并记录不良反应。结果:9例患儿口服格列卫后均达到遗传学缓解,缓解率100%(9/9),随访2~4年,中位数时间18个月时的总生存率67%。其中2例于治疗后13个月复发放弃治疗,1例于治疗后6个月复发行异基因造血干细胞移植术。患者在服药后16周(中位时间约3~4周)出现不同程度的血细胞减少。其中7例(78%)出现贫血,5例(56%)出现血小板减少,6例(67%)出现白细胞减少,3例(33%)为全血细胞减少,4例(44%)出现恶心、呕吐胃肠道反应,2例(22%)有肌肉疼痛,予以减量或停药后均可恢复正常。结论:格列卫治疗儿童Ph+ALL不仅有效而且安全。Objective： To observe the clinical effect of gleevec on Ph＋acute lymphoblastic leukaemia（ Ph~＋ALL） cases in children. Methods： 9 cases of children Ph~＋ALL were retrospectively analyzed. All of the data were obtained from department of hematology / oncology,in our hospital from January 2011 to May 2014. All the patients were treated with 340 mg / m^2·d of oral gleevec in 0. 5 h after meals,30 d for a course of treatment meanwhile,observed the genetics remission rate and recorded the occurrence of side effects treated with gleevec. Results： 9 cases（ 100%） were achieved complete genetic remission. With median follow-up time for 18 months,9 cases of survival rate of Ph＋ALL patients was 67% in 2 ~ 4 years. Of the patients,2 cases of recurrence after 13 months gave up treatment. 1 case was treated for allogeneic hematopoietic stem cell transplantation after recurrence. Different levels of hypocytosis occured after16 weeks（ medium time was approximately 3 ~ 4 weeks）. Including animia 7 cases（ 78%）,thrombocytopenia 5 cases（ 56%）,leukocytopenia 6 cases（ 67%）,pancytopenia 3 cases（ 33%）. Nausea and vomiting occurred in 4 cases（ 44%） and muscle pain occurred in 2 cases（ 22%） which returned to normal after discontinuation or reduction. Conclusion： Gleevec is both effective and safe for the treatment of Ph＋ALL.

关 键 词：格列卫 儿童 白血病 

分 类 号：R733.71[医药卫生—肿瘤]