初发慢性粒细胞白血病采用甲磺酸伊马替尼治疗临床检验观察  

Clinical Laboratory Observation on Imatinib Mesylate in Newly Diagnosed Chronic Myeloid Leukemia

作　　者：丁卓玲[1] 邓明凤[1] 

机构地区：[1]华中科技大学同济医学院附属荆州医院,湖北荆州434020

出　　处：《湖北中医药大学学报》2016年第4期109-112,共4页Journal of Hubei University of Chinese Medicine

摘　　要：目的 评价甲磺酸伊马替尼治疗初发慢性粒细胞白血病（CML）疗效和安全性。方法 28例初发慢性粒细胞白血病患者应用甲磺酸伊马替尼治疗,观察随访期内患者血液学、骨髓细胞学、细胞遗传学、分子遗传学改变、骨髓抑制及感染等不良反应。随访期结束后对2例有附加染色体异常的慢性期及8例进展期（5例加速期和3例急变期）患者进行追踪观察。结果 28例CML患者中位治疗和随访时间均为18个月,血液学总有效率为92.86%,细胞遗传学总有效率为85.71%,分子遗传学总有效率为60.71%。慢性期患者血液学、细胞遗传学及分子遗传学疗效明显优于进展期患者（P〈0.01,P〈0.05,P〈0.05）。治疗相关性不良反应多为1~2级,患者均能耐受完成治疗。结论 甲磺酸伊马替尼治疗CML慢性期能获得较好的血液学、细胞遗传学及分子遗传学疗效,对于进展期患者疗效较差。Objective To investigate the clinical efficacy and safety of Imatinib Mesylate in treatment of newly diagnosed chronic my- elogenous leukemia （CML）. Methods 28 cases of newly diagnosed CML patients were treated by Imatinib Mesylate. The hematology, bone marrow cytology, cytogeneties, molecular genetics, bone marrow suppression and adverse reactions, such as infection were observed in the follow - up period. After the follow - up period the observation of 2 cases in＇chronic phase with additional chromosome abnormality and 8 cases in advanced phase （5 cases in aeceleratied phase and 3 cases in blastie phase） were continued. Results The median duration of treat- ment and follow - up were both 18 months in the 28 patients. The total hematological effective rate was 92.86% , cytogenetic effective rate was 85.71% and molecular genetic effective rate was 60.71%. The hematological, cytogenetic and molecular genetic curative effect for the patients in chronic phase were obviously better than patients in advanced phase （P 〈 0.01, P 〈 0.05, P 〈 0.05）. Treatment - related ad- verse reactions were mostly grade 1 - 2 and were well - tolerated. Conclusion Imatinib Mesylate for CML patients in chronic phase can ob- tain better hematological, cytogenetic and molecular genetic curative effect, but for patients in advanced phase the effect is poor.

关 键 词：慢性粒细胞白血病 PH染色体 BCR-ABL融合基因 甲磺酸伊马替尼 

分 类 号：R733.72[医药卫生—肿瘤]