论文部分内容阅读
目的:总结甲磺酸伊马替尼(IM)治疗Ph阳性慢性粒细胞白血病(CML)患者的临床观察体会。方法:收集110例Ph阳性CML慢性期(CP)患者、6例加速期(AP)患者和4例急变期(BC)患者分别口服IM 400、600或800 mg/d。通过血液学、细胞遗传学和分子遗传学指标来判断疗效。结果:CP患者完全血液学反应(CHR)率、主要细胞遗传学反应(MCyR)率和完全细胞遗传学反应(CCyR)率分别为98.2%、90.9%和80.9%;AP分别为66.7%、33.3%和16.7%,P值分别为0.002、0.000和0.000。其中CP患者中肝肾功能不全的患者需减少IM剂量。27例经干扰素治疗失败的CP患者IM治疗仍有效。第1年高随访(1次/月)CP患者CCyR达81.9%,非高随访则为63.6%,P=0.005 2。服药前肾功能不全和肝功能不全较脏器功能正常的CP患者服药6个月内发生3~4级血液学毒副反应概率增高,服药6个月后有所减少。结论:IM对CP患者包括干扰素治疗失败的有较高疗效,对AP和BC患者有一定近期疗效。肝肾功能不全的患者易出现血液学毒副反应,需要药物剂量调整。
Objective: To summarize the clinical experience of imatinib mesylate (IM) in the treatment of patients with Ph-positive chronic myeloid leukemia (CML). Methods: One hundred and ten patients with Ph-positive CML chronic phase (CP) were enrolled. Six patients with accelerated phase (AP) and four patients with acute phase (BC) were orally administered with IM 400, 600 or 800 mg / d, respectively. Hematology, cytogenetics and molecular genetics indicators to determine the efficacy. Results: The complete hematologic response (CHR) rate, major cytogenetic response (MCyR) rate and complete cytogenetic response (CCyR) rates of CP patients were 98.2%, 90.9% and 80.9%, respectively; AP was 66.7% and 33.3 % And 16.7% respectively, with P values of 0.002, 0.000 and 0.000 respectively. In patients with liver and kidney dysfunction in patients with CP need to reduce the IM dose. The treatment of 27 patients with CP who had failed interferon treatment was still effective. In the first year of follow-up (1 month / month), CCyR was 81.9% in CP patients and 63.6% in non-high-follow-up patients, P = 0.005 2. Medication before renal insufficiency and liver dysfunction than normal function of CP patients taking medication within 6 months occurred 3 to 4 hematological toxic side effects increased the probability of medication after 6 months decreased. CONCLUSIONS: IM has a high efficacy in the failure of patients with CP, including interferon, and has some immediate efficacy in patients with AP and BC. Patients with liver and kidney dysfunction prone to hematological toxicities, need medication dose adjustment.