靶向治疗儿童慢性粒细胞白血病临床研究  

Clinicalresearch of children with chronic myeloid leukemia treated with targeted therapy

作　　者：李岩 郝国平[2] 王晓欢[2] 程艳丽[2] LI Yan;HAO Guoping;WANG Xiaohuan;CHENG Yanli(Department of Pediatrics,Shanxi Medical University,Taiyuan 030001,China;Department of Hematology,Shanxi Children′s Hospital,Taiyuan 030013,China)

机构地区：[1]山西医科大学儿科医学系,太原030001 [2]山西省儿童医院,太原030013

出　　处：《中国小儿血液与肿瘤杂志》2019年第1期27-31,共5页Journal of China Pediatric Blood and Cancer

摘　　要：目的观察靶向治疗慢性粒细胞白血病(CML)慢性期患儿的疗效及安全性。方法选取2014年1月1日-2017年12月31日在我院血液科确诊为初发CML慢性期的患儿共5例。其中,男1例,女4例,中位年龄10(6～11)岁,均予以口服伊马替尼300mg/(m^2·d)治疗。定期观察患儿临床表现、外周血象和分子生物学指标的变化,评估疗效,同时记录治疗期间不良反应发生情况。结果5例患儿中,4例经伊马替尼规范治疗3个月后获得完全血液学反应(CHR),且在治疗12个月时均获得主要分子学反应(MMR)。1例不耐受伊马替尼,换用达沙替尼治疗1个月后获得CHR,4个月后融合基因定量检测达最佳疗效。结论伊马替尼治疗儿童CML慢性期早期疗效确切,且不良反应较轻,耐受性好,较为安全。达沙替尼可使CML患儿达到更快、更深层次的缓解,在不耐受伊马替尼的情况下,可作为二线治疗选择。Objective To observe the efficacy and safety of targeted therapy in children with chronic myeloid leukemia(CML)in chronic phase.Methods A total of 5 children diagnosed with CML in chronic phase in the Department of Hematology in our hospital from January 1,2014 to December 31,2017 were selected.Among them,1 male and 4 female,with a median age of 10 years(6~11 years).All these patients were treated with imatinib 300mg/(m^2·d).The changes of clinical manifestations,peripheral blood and molecular biological indexes were observed regularly,and the adverse effects were evaluated.Results 4 of the 5 patients received CHR after 3 months of imatinib standard treatment,and received MMR at 12 months of treatment.1 case was imintinib intolerance,who changed to dasatinib treatment,CHR was obtained 1month later.After 4 months,the fusion gene quantitative test showed the best curative effect.Conclusions Imatinib is effective and safe in the treatment of children with CML chronic stage.Dasatinib can achieve a faster and deeper remission in children with CML,and can be selected as second-line treatment if imatinib is intolerant.

关 键 词：慢性粒细胞白血病 儿童 靶向治疗 疗效 安全性 

分 类 号：R733.72[医药卫生—肿瘤]