伊马替尼血浆谷浓度对慢性粒细胞白血病疗效影响的荟萃分析  

Meta-analysis on the correlation of drug trough concentration and imatinib response in patients with chronic myeloid leukemia

作　　者：姜志平[1] 赵谢兰[1] 孙莉[2] 曾晶[2] 王清[2] 徐萍[2] 

机构地区：[1]中南大学湘雅医院血液科,长沙410008 [2]中南大学湘雅二医院药学部,长沙410011

出　　处：《中南药学》2016年第8期877-883,共7页Central South Pharmacy

摘　　要：目的研究伊马替尼谷浓度(C_0)是否可以影响伊马替尼的临床反应。方法通过因特网搜索Pubmed数据库,收集从2003年至今的相关文献,收集不同C_0水平间达到不同临床反应患者例数的差异和直接研究达到不同临床反应患者体内C_0水平的差异的文献,并提取相关数据,采用STATA 12.0软件,使用随机效益模型进行荟萃分析。结果共有18项研究涉及2965名患者纳入本次荟萃分析。结果显示获得MMR患者C_0水平高于未获得MMR患者,两者间差异具有统计学意义(P=0.000),获得CCy R患者C_0水平高于未获得CCy R患者,两者间差异具有统计学意义(P=0.016)。本研究还发现C_0>1000 ng·m L^(-1)组较C_0<1000 ng·m L^(-1)组更易获得满意的临床反应(P=0.000)。结论本研究证实伊马替尼的血浆C_0与其治疗效果存在显著相关性,这项结论可作为支持临床开展伊马替尼治疗药物浓度监测(TDM)和遗传药理学研究的依据。Objective To conduct a meta-analysis of significant magnitude to determine the influence of trough concentration（C_0） on the imatinib clinic response in chronic myeloid leukemia（CML） patients. Methods Literatures were retrieved to locate the related papers by using Pub Med electronic source from 2003 till today. Related data were collected and meta-analysis was performed by using STATA 12.0. Results A total of 18 papers concerning 2965 subjects were included in this meta-analysis. The overall results showed the patients who achieved MMR had significantly higher C_0 of imatinib than those who failed to achieve MMR. We also found those patients who achieved CCy R had significantly higher C_0 of imatinib than those who did not. The rate of MMR and overall response achievement was significantly higher in patients with an imatinib C_0 over 1000 ng·m L（-1） than in patients with a C_0 under 1000 ng·m L（-1）. Conclusion There is a significant correlation between the imatinib C_0 and clinic responses, which highlights the importance of pharmacogenetic investigation among large cohort of CML patients.

关 键 词：伊马替尼 谷浓度 慢性粒细胞白血病 疗效 荟萃分析 

分 类 号：R733.7[医药卫生—肿瘤]