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目的观察伊马替尼、尼洛替尼和达沙替尼对慢性粒细胞白血病(CML)慢性期患者治疗的有效性和安全性。方法 123例接受酪氨酸激酶抑制剂治疗的慢性粒细胞白血病慢性期患者分成3组:A组64例接受伊马替尼治疗;B组31例接受尼洛替尼治疗,C组28例接受达沙替尼治疗,对患者临床资料和随访记录进行总结和分析。治疗18个月后,分析患者的完全细胞遗传缓解百分率(CCyR)、完全血液学缓解率(CHR)和主要分子生物学缓解率(MMR)。结果 A组治疗3,6,12,18个月后CCyR、CHR和MMR都呈现出上升趋势。B和C组治疗12,18个月时,CCyR较A组有显著提高(P<0.05);MMR与A组比较差异有显著统计学意义(P<0.01);3组CHR在各时间节点差异无统计学意义(P>0.05)。3组在随访期间的安全性差异无统计学意义(P>0.05)。结论与伊马替尼相比,尼洛替尼和达沙替尼能更快的在患者体内获得完全细胞遗传学缓解和主要分子生物学缓解,且疗效优于伊马替尼。
Objective To observe the efficacy and safety of imatinib, nilotinib and dasatinib in the treatment of patients with chronic myelogenous leukemia (CML) in chronic phase. Methods One hundred and twenty patients with chronic myelogenous leukemia treated with tyrosine kinase inhibitors were divided into three groups: 64 patients in group A received imatinib; 31 patients in group B received nilotinib treatment; 28 patients in group C received Dasatinib treatment, the patient’s clinical data and follow-up records were summarized and analyzed. After 18 months of treatment, the patients were analyzed for percent complete cytogenetic response (CCyR), complete hematologic response rate (CHR), and major molecular biological response rate (MMR). Results CCyR, CHR and MMR showed an upward trend after 3, 6, 12, 18 months of treatment in group A. In group B and C, the CCyR was significantly higher than that in group A at 12 and 18 months (P<0.05); the difference between MMR and group A was statistically significant (P<0.01); No statistical significance (P>0.05). There was no significant difference in the safety of the three groups during follow-up (P>0.05). CONCLUSION: Compared with imatinib, nilotinib and dasatinib can achieve complete cytogenetic remission and major molecular biological remission in patients faster than imatinib.