羟基脲联合沙利度胺治疗JAK2V617F阳性骨髓增殖性肿瘤的临床疗效及安全性评价  

Clinical efficacy and safety evaluation of hydroxyurea combined with thalidomide in the treatment of JAK2V617F positive myeloproliferative neoplasms

作　　者：宋腾飞 王晓晶[1] 马丽丽[2] SONG Tengfei;WANG Xiaojing;MA Lili(Department of Laboratory Medicine,Chifeng Municipal Hospital,Chifeng,024000,Inner Mongolia,China;Department of Hematology,Chifeng Municipal Hospital,Chifeng,024000,Inner Mongolia,China)

机构地区：[1]赤峰市医院检验科,内蒙古赤峰024000 [2]赤峰市医院血液科,内蒙古赤峰024000

出　　处：《肿瘤药学》2024年第4期468-473,共6页Anti-Tumor Pharmacy

基　　金：赤峰市自然科学科研课题(SZR21210)。

摘　　要：目的研究羟基脲联合沙利度胺治疗JAK2V617F阳性骨髓增殖性肿瘤(MPN)的临床疗效及安全性评价。方法采用前瞻性分析方法,选取2020年1月—2023年1月在我院门诊或住院接受荧光定量PCR检测确定为JAK2V617F阳性MPN的患者80例为研究对象,根据治疗方案分为观察组(40例)与对照组(40例)。对照组采用沙利度胺治疗,观察组患者采用羟基脲联合沙利度胺治疗。统计并比较两组患者治疗前及治疗后6、12个月的临床疗效,JAK2V617F突变负荷,血小板(PLT)、白细胞(WBC)、血红蛋白(HGB)、红细胞比容(HCT)水平,骨髓纤维化程度,骨髓形态学及用药安全性。结果治疗后,观察组总有效率显著高于对照组(P<0.05);治疗后6、12个月,两组患者JAK2V617F突变负荷,PLT、HGB水平,MPN-10评分,MF分级均显著低于治疗前,且观察组均显著低于对照组(P<0.05);而WBC、HCT水平无明显变化(P>0.05);观察组患者骨髓细胞异常增生发生率明显低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论羟基脲联合沙利度胺治疗JAK2V617F阳性MPN患者具有显著效果,可有效改善临床症状,降低JAK2V617F阳性突变负荷,逆转骨髓纤维化水平。Objective To study the clinical efficacy and safety of hydroxyurea combined with thalidomide in the treat-ment of JAK2V617F positive myeloproliferative neoplasms(MPN).Methods A prospective analysis was conducted,involv-ing 80 patients diagnosed with JAK2V617F positive myeloproliferative neoplasms via quantitative PCR at our hospital from January 2020 to January 2023.The patients were divided into an observation group(40 cases)and a control group(40 cas-es)based on the treatment method.The observation group received a combination of hydroxyurea and thalidomide,while the control group received conventional thalidomide treatment alone.The clinical efficacy,incidence of adverse reactions and bone marrow morphology were compared between the two groups,as well as the JAK2V617F mutation burden,the lev-els of platelet(PLT),white blood cell(WBC),hemoglobin(HGB)and hematocrit(HCT),and the myelofibrosis degrees of the two groups before treatment and 6 and 12 months after treatment.Results After treatment,the total effective rate of the ob-servation group was significantly higher than that of the control group(P<0.05).At 6 and 12 months after treatment,the JAK2V617F mutation load,the levels of PLT and HGB,the MPN-10 score and MF grade in the two groups were significant-ly lower than those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).However,there was no significant change in WBC and HCT levels(P>0.05).The incidence of abnormal proliferation of bone marrow cells in the observation group was significantly lower than that in the control group(P<0.05).No statistically significant differences were found in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Hydroxyurea combined with thalidomide treatment is effective for JAK2V617F positive myeloproliferative neo-plasm patients.It can significantly improve the clinical symptoms,reduce JAK2V617F mutation burden,and reverse myelo-fibrosis.

关 键 词：骨髓增殖性肿瘤 JAK2V617F阳性 羟基脲 沙利度胺 

分 类 号：R733.3[医药卫生—肿瘤]