化疗联合索拉非尼治疗FLT3-ITD阳性AML的疗效研究  

Efficacy of chemotherapy combined with sorafenib for FLT3-ITD-positive acute myeloid leukemia

作　　者：王雪梅 杨正鹏 郭珩[1] 黄天骄 李金凤 安博 杨雪 周虹[1] Wang Xuemei;Yang Zhengpeng;Guo Heng;Huang Tianjiao;Li Jinfeng;An Bo;Yang Xue;Zhou Hong(Department of Hematology,The Second Affiliated Hospital of Qiqihar Medical University,Qiqihar 161000,Heilongjiang Province,China;Department of Hematology,The Third Affiliated Hospital of Qiqihar Medical University,Qiqihar 161000,Heilongjiang Province,China)

机构地区：[1]齐齐哈尔医学院附属第二医院血液科,齐齐哈尔161000 [2]齐齐哈尔医学院附属第三医院血液科,齐齐哈尔161000

出　　处：《中国基层医药》2022年第12期1807-1812,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：黑龙江省齐齐哈尔市科技计划联合引导项目(LHYD-202042)。

摘　　要：目的探讨化疗联合索拉非尼方案对Fms样酪氨酸激酶3基因内部串联重复序列(FLT3-ITD)阳性急性髓系白血病(AML)患者预后的影响,从而寻找更有效的治疗方案。方法回顾性分析齐齐哈尔医学院附属第二医院2015年1月至2017年1月收治的初治AML患者60例的临床资料,按FLT3-ITD阳性与否及治疗方法分为三组,观察组(FLT3-ITD阳性,n=19)在常规化疗基础上联合索拉非尼治疗,对照组1(FLT3-ITD阳性,n=21)在化疗基础上未联合索拉非尼治疗,对照组2(FLT3-ITD阴性,n=20)常规化疗。比较三组第1个疗程、第4个疗程治疗后的效果。结果第1个疗程后,对照组2完全缓解率为50.0%(10/20),高于观察组[15.8%(3/19)]和对照组1[4.8%(1/21)],差异有统计学意义(H=13.39,P<0.05);第4个疗程后,观察组、对照组2、对照组1完全缓解率分别为63.2%(12/19)、60.0%(12/20)、4.8%(1/21),差异有统计学意义(H=19.21,P<0.05)。随访4年,观察组、对照组1、对照组2中位生存期分别为36.63、24.15、45.00个月,无事件生存期分别为18.00、9.82、24.90个月,对照组2中位生存期、无事件生存期均长于观察组、对照组1(χ^(2)=19.93、23.04,均P<0.001)。结论采用化疗联合索拉非尼方案治疗初治FLT3-ITD阳性AML,患者可综合获益并获得生存优势。Objective To investigate the effect of chemotherapy combined with sorafenib on the prognosis of FLT3 internal tandem duplication(FLT3-ITD)-positive acute myeloid leukemia and to find a more effective treatment.Methods The clinical data of 60 patients who were newly diagnosed with acute myeloid leukemia and who received treatment in The Second Affiliated Hospital of Qiqihar Medical University from January 2015 to January 2017 were retrospectively analyzed.The patients were divided into three groups according to whether they were positive for FLT3-ITD and the treatment method they used.The observation group(FLT3-ITD-positive,n=19)were treated with sorafenib based on routine chemotherapy.The control group 1(FLT3-ITD-positive,n=21)was treated only with routine chemotherapy.The control group 2(FLT3-ITD-negative,n=20)was treated only with routine chemotherapy.After the first and fourth courses of treatment,clinical efficacy was compared among the three groups.Results After the first course of treatment,the complete remission rate in control group 2 was 50.0%(10/20),which was significantly higher than 15.8%(3/19)in the observation group and 4.8%(1/21)in the control group 1(H=13.39,P<0.05).After the fourth course of treatment,the complete remission rate in the observation group,control group 2,and control group 1 was 63.2%(12/19),60.0%(12/20),and 4.8%(1/21),respectively,and the differences were statistically significant(H=19.21,P<0.05).Four-year follow-up results showed that the median survival time in the observation group,control group 1,and control group 2 was 36.63,24.15,and 45.00 months respectively.The event-free survival in the observation group,control group 1,and control group 2 was 18.00,9.82,and 24.90 months,respectively.The median survival time and the event-free survival in the control group 2 were significantly longer than those in the observation group and control group 1(χ^(2)=19.93,23.04,both P<0.001).Conclusion Chemotherapy combined with sorafenib for treating newly-diagnosed FLT3-ITD-positive acute my

关 键 词：白血病 髓样 急性 fms样酪氨酸激酶3 基因 抑制 串联重复序列 药物疗法 联合 抗肿瘤联合化疗方案 索拉非尼 回顾性研究 

分 类 号：R733.71[医药卫生—肿瘤]