干扰素α和羟基脲治疗JAK2V617F基因突变阳性骨髓增殖性肿瘤的临床分析  

Therapeutic Effect of Interferon Alpha And Hydroxyurea on JAK2V617F Mutation-positive Patients with Myeloproliferative Neoplasm

作　　者：黄晓春 秦丽娟 梁晔 李小梅 HUANG Xiao-chun;QIN Li-juan;LIANG Ye;LI Xiao-mei(Department of Hematology,Guilin People's Hospital,Guilin,Guangxi,541002 China)

机构地区：[1]桂林市人民医院血液科,广西桂林541002

出　　处：《中外医疗》2020年第3期93-96,共4页China & Foreign Medical Treatment

摘　　要：目的回顾性分析羟基脲和干扰素(IFN-α)治疗JAK2V617F基因突变阳性骨髓增殖性肿瘤(MPN)的临床疗效。方法方便选取2015-2018年符合诊断标准的JAK2V617F阳性MPN患者39例,其中真性红细胞增多症(PV)20例,原发性血小板增多症(ET)19例。根据药物治疗将患者分对照组(20例,给予羟基脲治疗,其中PV患者8例,ET患者12例);观察组(19例,给予IFN-α治疗,其中PV患者12例,ET患者7例);记录患者的血常规、症状和体征。检测治疗前、治疗后半年,治疗后1年JAK2V617F基因突变比例。记录骨髓细胞形态学、骨髓病理学检查结果,观察疾病无进展生存情况和药物不良反应。结果观察组血常规、体征缓解率分别为78.9%,75.0%,差异无统计学意义(χ~2=0.086,P=0.770)。治疗前观察组、对照组JAK2V617F突变比例分别为﹙42.14±15.09﹚%、﹙37.63±17.65﹚%,差异无统计学意义(t=-0.855,P=0.398)。治疗半年后观察组、对照组的基因突变比例下降分别为﹙20.72±1.51﹚%、﹙5.75±0.47﹚%,差异有统计学意义(t=-9.494, P=0.000)。治疗1年后观察组、对照组基因突变比例下降分别为﹙32.38±2.62﹚%、﹙20.07±0.86﹚%,差异有统计学意义(t=4.454,P=0.000)。治疗1年后基因突变下降明显多于治疗半年(观察组t=-3.852,P=0.001,对照组t=-15.194,P=0.000)。观察组、对照组无疾病进展生存率94.7%(18/19)、90.0%(18/20),差异无统计学意义(χ~2=0.308,P=0.579)。药物不良反应在观察组明显,患者可以耐受。结论 IFN-α和羟基脲治疗JAK2V617F基因突变阳性MPN均有临床疗效。干扰素降低JAK2V617F基因突变比例更明显。Objective The clinical efficacy of hydroxyurea and interferon(IFN-α) in the treatment of JAK2 V617 F gene mutation-positive bone marrow proliferative tumors(MPN) was retrospectively analyzed. Methods Convenient selection 39 patients with JAK2 V617 F positive MPN who met the diagnostic criteria from 2015 to 2018 were selected, including 20 cases of true erythrocytosis(PV) and 19 cases of primary thrombocytosis(ET). Patients were divided into control groups according to drug treatment(20 cases, treated with hydroxyurea, of which 8 were PV patients and 12 were ET patients);the observation group(19 cases treated with IFN-α, of which 12 were PV patients and 7 were ET patients);Record the patient’s blood routine, symptoms and signs. The proportion of JAK2 V617 F gene mutations was detected before treatment, six months after treatment, and one year after treatment. The results of bone marrow cell morphology and bone marrow pathology were recorded, and the disease-free survival and adverse drug reactions were observed. Results The blood and routine remission rates of the treatment group and observation group were 78.9% and 75.0%, the difference was not statistically significant(χ~2=0.086, P=0.770). The percentages of JAK2 V617 F mutations in the observation group and the control group before treatment were﹙42.14±15.09﹚% and﹙37.63±17.65﹚%, the difference was not statistically significant(t=-0.855, P=0.398). After half a year of treatment, the percentage of gene mutations in the observation group and control group decreased by﹙20.72±1.51﹚% and﹙5.75±0.47﹚%, respectively, and the difference was statistically significant(t=-9.494, P=0.000). After one year of treatment, the proportion of gene mutations in the observation group and control group decreased by ﹙32.38±2.62﹚% and ﹙20.07±0.86﹚%, respectively, and the differences were statistically significant(t=4.454, P=0.000). After one year of treatment, the genetic mutation decreased significantly more than half a year of treatment(observation g

关 键 词：骨髓增殖性肿瘤 JANUS激酶2 突变 干扰素Α 羟基脲 

分 类 号：R719[医药卫生—妇产科学] R551.3[医药卫生—临床医学]