达沙替尼联合PEG-ASP化疗方案治疗Ph阳性急性淋巴细胞白血病的疗效及对血清TK1及uPA水平的影响  

Effects of dasatinib combined with PEG-ASP chemotherapy on the serum levels of TK1 and uPA in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia

作　　者：冯传杰[1] 拓慧[2] Feng Chuanjie;Tuo Hui(Department of Emergency;Department of Pain Medicine,The Affiliated Hospital of Yan＇an University,Yan＇an 716000,China)

机构地区：[1]陕西省延安大学附属医院急诊科,延安716000 [2]陕西省延安大学附属医院疼痛科,延安716000

出　　处：《广西医科大学学报》2018年第10期1354-1357,共4页Journal of Guangxi Medical University

摘　　要：目的:探讨达沙替尼联合培门冬酶(PEG-ASP)化疗方案治疗Ph阳性急性淋巴细胞白血病(Ph+ALL)的疗效及其对血清胸苷激酶1(TK1)及尿激酶型纤溶酶原激活物(uPA)水平的影响。方法:选取2012年6月至2013年12月陕西省延安大学附属医院收治的46例初诊Ph+ALL患者,按随机数字表法分为对照组和观察组,每组23例。对照组给予PEG-ASP化疗方案治疗,观察组在PEG-ASP化疗方案基础上加用达沙替尼治疗。分别于化疗前、后检测血清TK1和uPA浓度,比较两组临床疗效、不良反应发生率及3年无事件生存(EFS)率。结果:观察组总缓解(OR)率为86.96%,显著高于对照组的43.48%(P<0.01)。两组患者不良反应发生率比较,差异无统计学意义(均P>0.05)。两组化疗后血清TK1和uPA水平均较治疗前显著降低,且观察组显著低于对照组(P<0.01)。观察组3年EFS率为69.57%,显著高于对照组34.78%(P<0.05)。结论:达沙替尼联合PEG-ASP化疗方案治疗Ph+ALL的疗效显著,能有效降低患者血清TK1和uPA水平,延长EFS,且不增加毒副反应,值得临床推广应用。Objective：To investigate the effects of dasatinib combined with PEG-ASP chemotherapy on the serum levels of thymidine kinase 1（TK1）and urokinase type plasminogen activator（uPA）in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia（Ph＋ALL）.Methods：A total of 46 patients with Ph＋ALL treated in our hospital from June 2012 to December 2013 were selected,and randomly assigned to receive either PEG-ASP chemotherapy（n=23,control group）or dasatinib combined with PEGASP chemotherapy（n=23,observation group）.The TK1 and uPA levels in serum were detected.The clinical efficacy,the incidence of adverse reactions and 3-year event free survival（EFS）rate were compared.Results：After treatment,the overall response rate in the observation group was 86.96%,which was significantly higher than that in the control group（43.48%）（P〈0.01）.There was no significant difference in the incidence of adverse reactions between the two groups（P〉0.05）.The serum TK1 and uPA levels after treatment were notably decreased,and the decrease was more significant in the observation group（P〈0.01）.The 3-year EFS rate in the observation group was 69.57%,which was significantly higher than that in the control group（34.78%）（P〈0.05）.Conclusion：Dasatinib combined with PEG-ASP chemotherapy was effective for Ph＋ALL.It could reduce the TK1 and uPA levels in serum and prolong EFS,and did not increase the adverse reactions.

关 键 词：达沙替尼 培门冬酶 Ph阳性急性淋巴细胞白血病 TK1 UPA 

分 类 号：R733.7[医药卫生—肿瘤]