STI 571治疗慢性期慢性粒细胞白血病的初步结果分析  

STI 571 for treating 19 patients with chronic-phase chronic myeloid leukemia

作　　者：孟凡义[1] 郑维扬[1] 刘晓力[1] 徐兵[1] 宋兰林[1] 张钰[1] 黄芬[1] 

机构地区：[1]第一军医大学南方医院血液科,广东广州510515

出　　处：《第一军医大学学报》2003年第11期1149-1150,共2页Journal of First Military Medical University

基　　金：广东省社会发展攻关课题(B30202)~~

摘　　要：目的观察STI 571治疗慢性粒细胞白血病慢性期(CML-CP)与加速期(CML-AP)患者的疗效差异.方法19例CML患者(Ph染色体阳性率和/或荧光原位杂交(FISH)检测双标双融合bcr/abl基因阳性率均＞90%)的中位年龄38岁,12例曾经干扰素-α(IFN-α)治疗失败.CML-AP 5例,CML-CP 14例,其中CML-CP早期(诊断≤1年)9例,CML-CP晚期(诊断3～6年)5例.19例患者全部服用STI 571 300～500mg/d,其中5例CML-AP同时联用高三尖杉酯硷1～2 mg/d,7～14 d为1疗程(中位数疗程1.5个).治疗的中位数时间4.5个月,治疗≥3个月后复查Ph染色体和FISH-bcr/abl.结果CML患者的血液学完全缓解率为100%,主要细胞遗传学反应率79%:CML-CP早期患者的细胞遗传学完全缓解率高于CML-CP晚期和CML-AP的患者(88.9%vs40.0%vs0%).结论STI 571治疗CML的血液学完全缓解率高,细胞遗传学反应率在CML-CP早期的患者中最高.Objective To compare the therapeutic effects of STI 571 in treating Philadelphia chromosome (Ph)-positive patients with chronic-phase and acceleration phase chronic myeloid leukemia (CML-CP and CML-AP, respectively). Methods A total of 19 CML patients with Ph chromosome and/or fluorescence in situ hybridization (FISH)-bcr/abl fusion gene positivity rates over 90% and a median age of 38 years were recruited in this study, 12 of whom had previously failed to respond to interferon-α. Five of the 19 patients were in accelerated phase and 14 in chronic phase, 9 of the latter patient group in early stage of CML-CP (within 1 year since diagnosis) and 5 in advanced stage (3-6 years since diagnosis). All the patients were given oral STI 571 at the dose of 300-500 mg/d for a median treatment course of 5 months, and the 5 patients with CML-AP also received homoharringtonine at dose of 1-2 mg/d for an average of 1.5 treatment cycles (7-14 d for a complete treatment cycle). The Ph chromsome and the FISH-bcr/abl were analysed again 3 months after the treatment. Results STI 571 induced 100% complete hematological remission (CHR) and 79% major cytogenetic responses (MCR) in these patients. The complete cytogenetic remisson (CCR) rates of CML-AP patients and CML-CP patients in advanced stage were lower than that of CML- CP patients in early stage (0% and 40% vs 88.9%). Conclusion STI 571 can achieve high rate of CHR and MCR in CML-CP patients, especially in those in early stage of the disease.

关 键 词：STI571 治疗 慢性期慢性粒细胞白血病 慢性期 加速期 格列卫 

分 类 号：R733.72[医药卫生—肿瘤] R730.53[医药卫生—临床医学]