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目的:探讨伊马替尼治疗慢性髓性白血病(chronic myelocytic leukemia,CML)后的3、6个月时的BCR-ABL转录本水平在疗效监测中的价值,为CML患者早期干预提供依据。方法:观察了128例初诊慢性期CML患者,分析伊马替尼治疗后3、6个月时的不同的BCR-ABL水平与后续的完全细胞遗传学反应(CCy R)和主要分子学反应(MMR)的关系。结果:CML患者达EMR(早期分子学反应,3个月时BCR-ABL≤10%)患者比EMR失败(3个月BCR-ABL>10%)的患者在后续的时间点有更高的CCy R和MMR(P<0.05)。在EMR失败的患者中,6个月BCR-ABL≤1%的患者组疗效与EMR组比较差异无统计学意义(P>0.05),而BCR-ABL介于1%~10%及>10%的患者与EMR组比较均存在统计学差异(P<0.05)。结论:CML慢性期患者伊马替尼治疗后的达EMR及EMR失败后6个月BCR-ABL≤1%能够预示良好的预后,推测可以作为早期干预的依据之一。
Objective: To investigate the value of BCR-ABL transcript level at 3 and 6 months after imatinib treatment of chronic myelocytic leukemia (CML) in curative effect monitoring, and to provide basis for early intervention in CML patients. Methods: A total of 128 patients with newly diagnosed chronic CML were enrolled. The different BCR-ABL levels at 3 and 6 months after imatinib treatment were compared with subsequent complete cytogenetic (CCy R) and major molecular responses MMR) relationship. RESULTS: Patients with CML had higher CCy at subsequent time points than those who failed EMR (3-month BCR-ABL> 10%) in patients with EMR (early molecular response, BCR-ABL ≤10% at 3 months) R and MMR (P <0.05). In patients with failed EMR, the efficacy of 6-month BCR-ABL≤1% was not significantly different from that of EMR (P> 0.05), while the BCR-ABL ranged from 1% to 10% and> 10% Of patients had statistically significant difference compared with EMR group (P <0.05). CONCLUSIONS: BCR-ABL ≤1% at 6 months after IMRT and IMR failure in patients with chronic CML can predict good prognosis after Imatinib treatment, which may be one of the evidences for early intervention.