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目的评价甲磺酸伊马替尼治疗初发慢性粒细胞白血病(CML)疗效和安全性。方法 28例初发慢性粒细胞白血病患者应用甲磺酸伊马替尼治疗,观察随访期内患者血液学、骨髓细胞学、细胞遗传学、分子遗传学改变、骨髓抑制及感染等不良反应。随访期结束后对2例有附加染色体异常的慢性期及8例进展期(5例加速期和3例急变期)患者进行追踪观察。结果 28例CML患者中位治疗和随访时间均为18个月,血液学总有效率为92.86%,细胞遗传学总有效率为85.71%,分子遗传学总有效率为60.71%。慢性期患者血液学、细胞遗传学及分子遗传学疗效明显优于进展期患者(P<0.01,P<0.05,P<0.05)。治疗相关性不良反应多为1~2级,患者均能耐受完成治疗。结论甲磺酸伊马替尼治疗CML慢性期能获得较好的血液学、细胞遗传学及分子遗传学疗效,对于进展期患者疗效较差。
Objective To evaluate the efficacy and safety of imatinib mesylate in the treatment of primary chronic myeloid leukemia (CML). Methods A total of 28 patients with newly diagnosed CML were treated with imatinib mesylate. The adverse reactions such as hematology, myelocytology, cytogenetics, molecular genetics, myelosuppression and infection were observed during the follow-up period. At the end of the follow-up period, 2 chronic patients with additional chromosomal abnormalities and 8 patients with advanced disease (5 patients with accelerated phase and 3 patients with acute phase) were followed up. Results The median duration of treatment and follow-up of 28 CML patients were 18 months. The total effective rate of hematology was 92.86%. The total effective rate of cytogenetics was 85.71%. The total effective rate of molecular genetics was 60.71%. The efficacy of hematology, cytogenetics and molecular genetics in patients with chronic phase were significantly better than those in advanced stage (P <0.01, P <0.05, P <0.05). Treatment-related adverse reactions mostly 1 to 2, patients can tolerate the completion of treatment. Conclusion Imatinib mesylate treatment of chronic CML can get better hematology, cytogenetics and molecular genetics efficacy, poor efficacy in patients with advanced disease.