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目的观察甲磺酸伊马替尼治疗慢性粒细胞白血病(CML)的临床疗效。方法收集并分析海南省人民医院血液内科诊治的30例慢性粒细胞白血病患者,使用甲磺酸伊马替尼进行治疗,并监测临床疗效及不良反应等情况。结果完全血液学缓解(CHR)率在CML慢性期患者为93.3%,进展期为40%;主要细胞遗传学缓解(MCy R)率在CML慢性期患者为86.7%,进展期为33.3%;完全分子学缓解(CMOR)率在CML慢性期患者为80%,进展期为20%;两组患者之间差异有统计学意义(P<0.05)。CP患者1年、2年、3年、5年生存率分别为100%、94.7%、89.8%和86.5%,无进展生存率分别为92.7%、85.3%、82.6%和70.6%;AP患者1年、2年、3年生存率分别为91.5%、38.1%和37.2%,预期无进展生存率分别为39.1%、29.3%和18.6%;BP患者1年、2年的预期生存率分别为84.1%、31.7%。CP患者生存率及无进展生存率高于AP、BP患者(P<0.05)。结论甲磺酸伊马替尼治疗慢性粒细胞白血病慢性期患者的临床疗效优于加速期和急变期。
Objective To observe the clinical efficacy of imatinib mesylate in the treatment of chronic myeloid leukemia (CML). Methods Thirty patients with chronic myeloid leukemia diagnosed and treated in Department of Hematology, Hainan Provincial People ’s Hospital were collected and analyzed. The patients were treated with imatinib mesylate and the clinical efficacy and adverse reactions were monitored. Results The complete hematological response (CHR) rate was 93.3% in chronic phase of CML and 40% in advanced stage. The rate of major cytogenetic response (MCy R) was 86.7% in chronic phase of CML and 33.3% in advanced stage The CMOR rate was 80% in chronic phase of CML and 20% in advanced stage. The difference between the two groups was statistically significant (P <0.05). The 1-year, 2-year, 3-year and 5-year survival rates of patients with CP were 100%, 94.7%, 89.8% and 86.5% respectively, and the progression-free survival rates were 92.7%, 85.3%, 82.6% and 70.6% Year, 2-year and 3-year survival rates were 91.5%, 38.1% and 37.2%, respectively. The expected progression-free survival rates were 39.1%, 29.3% and 18.6% respectively. The expected survival rates at 1 year and 2 years in BP patients were 84.1 %, 31.7%. The survival rate and progression-free survival rate of CP patients were higher than those of AP and BP patients (P <0.05). Conclusion The clinical efficacy of imatinib mesylate in the treatment of patients with chronic myeloid leukemia is better than that in the accelerated and abrupt phases.