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目的评估伊马替尼治疗慢性期慢性髓细胞白血病(CML)的早期分子反应(EMR)。方法回顾性分析我院自2011年4月至2014年3月应用伊马替尼治疗的39例CML慢性期EMR的患者,并分析影响EMR的因素。结果 39例CML患者可评估38例,EMR率61%。其中,低、中危组EMR率70%(19/27),高危组EMR率36%(4/11)。高危组与中、低组比较,EMR率明显减低(P<0.05)。EMR患者和EMR失败患者,例数分别为23例和15例;初诊时肋缘下脾脏大小分别为4.0(QR=1.5)cm,11.3(QR=1.6)cm(P<0.05);白细胞计数分别为23(QR=4.0)×10~9/L,35(QR=8.9)×10~9/L(P<0.05)。结论初诊时脾脏大、白细胞计数高、Sokal评分高危可能与伊马替尼治疗CML的EMR失败相关。
Objective To evaluate the early molecular response (EMR) of imatinib in the treatment of chronic myelogenous leukemia (CML). Methods A retrospective analysis of 39 patients with CML chronic phase EMR who were treated with imatinib in our hospital from April 2011 to March 2014 was performed and the factors influencing EMR were analyzed. Results 39 cases of CML patients were evaluated in 38 cases, EMR rate of 61%. Among them, the EMR rate was 70% (19/27) in the low-risk group and 36% (4/11) in the high-risk group. The high-risk group compared with the middle and low groups, the EMR rate was significantly lower (P <0.05). The number of patients with EMR and patients with failed EMR were 23 and 15 respectively. The size of the spleen margin under the marginal margin was 4.0 (QR = 1.5) cm and 11.3 (QR = 1.6) cm (P <0.05) (QR = 4.0) × 10 ~ 9 / L, 35 (QR = 8.9) × 10 ~ 9 / L (P <0.05). Conclusions The newly diagnosed spleen is large and the white blood cell count is high. The high risk of Sokal score may be related to the failure of EMR in the treatment of CML with imatinib.