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甲磺酸伊马替尼治疗慢性粒细胞白血病的临床观察 被引量:6

Experience of imatinib in the treatment of chronic myelogenous leukemia
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摘要 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 experience of imatinib mesylate(IM) in the treatment of patients with Philadelphia chromosome-positive(Ph-positive) chronic myeloid leukemia(CML).METHODS:Totally 110 patients with Ph-positive CML in chronic phase(CP) were treated with IM 400 mg/d;6 CML patients of accelerated phase(AP) and 4 CML patients with blastcrisis(BC) were treated with IM 600 mg/d and 800 mg/d respectively.RESULTS: Overall complete hematological response(CHR) rate,major cytogenetic response(MCyR) rate and complete cytogenetic response(CCyR) rate of CP were 98.2%,90.9% and 80.9% respectively;while those of AP were 66.7%,33.3% and 16.7%(P were 0.002,0.000 and 0.000).Dose reductions were performed in of 97 patients with renal and liver dysfunction.IM was effective in 27 patients with CP who failed in previous IFN-α therapy.CCyR of CP patients with high follow-up(every 1 months)of CP patients was 81.9% in the first 12 months,however,of CP patients with non high follow-up was 63.6%(P=0.005 2);The rate of grade 3-4 hematologic toxicities of patients with pre-existing renal dysfunction and liver dysfunction was more than that of normal organ function during intitial 6 months after treatment with IM.After 6 months,the adverse events were lower.CONCLUSIONS: IM induced MCyR and CCyR of patients with CP including patients who failed in previous IFN-α therapy are achieved by neceiving IM.Most patients with pre-existing liver and/or renal dysfunction may have a higher rate of hematologic toxicity and required more frequent dose reductions.
出处 《中华肿瘤防治杂志》 CAS 2011年第14期1121-1124,共4页 Chinese Journal of Cancer Prevention and Treatment
关键词 白血病 髓样 慢性 甲磺酸伊马替尼 抗肿瘤药/治疗应用 治疗结果 leukemia myeloid chronic imatinib mesylate antineoplastic agents/therapeatic uses therapeatic outcome
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  • 1Baccarani M, Cortes J, Pane F, et al. European LeukemiaNet. Chronic myeloid leukemia: an update of concepts and manage- ment recommendations of european leukemia net[J]. J Clin On col, 2009, 27(35) :6041-6051.
  • 2Tong W G, Kantarjian H, O'Brien S, et al. Imatinib front line therapy is safe and effective in patients with chronic myelogenous leukemia with pre existing liver and/or renal dysfunction[J]. Cancer, 2010,116(13):3152-3159.
  • 3王建祥.慢性髓性白血病治疗专家共识(2010版)[J].中华血液学杂志,2010,31(3):214-216. 被引量:23
  • 4高广勋 陈协群 白庆咸 等.多重巢式RT-PCR快速检测常见白血病融合基因492例.中国实验血液学杂志,2009,:28-29.
  • 5cancer therapy evaluation program. OCTD/NIH. Common ter- minology critera for adverse events(CTCAE) ,Verson3.0. Rock- ville, MD: Capital technology information services, 2003.
  • 6Cilloni D, Messa E, Rotolo A, et al. Emerging drugs for chronic myeloid leukemia[J]. Expert Opin Emerg Drugs, 2010,15 (2) : 175-184.
  • 7王建祥,黄晓军,吴德沛,胡建达,刘霆,胡豫,孟凡义,陈协群,侯明,李艳,王书杰,王健民,任汉云,于力,陈芳源,邱录贵,江滨,孙爱宁,刘庭波,朱焕玲,郭涛,徐丹,纪春岩,吕晓毅,焦力,宋献民,黄洪晖.中国15家医院慢性粒细胞白血病发病状况及目前诊断治疗模式调查分析[J].中华血液学杂志,2009,30(11):721-725. 被引量:26
  • 8Marin D, Bazeos A, Mahon F X, et al. Adherence is the critical factor for achieving molecular responses in patients with chronic myeloid leukemia who achieve complete cytogenetic responses on imatinib[J]. J Clin Oncol,2010, 28(14) :2381- 2388.
  • 9Wu E Q, Johnson S, Beaulieu N, et al. Healthcare resource uti lization and costs associated with non-adherence to imatinib treatment in chronic myeloid leukemia patients[J]. Curr Med Res Opin, 2010, 26(1):61- 69.
  • 10Kantarjian H M, Cortes J, La Ros6e P, et al. Optimizing thera- py {or patients with chronic myelogenous leukemia in chronic phase[J]. Cancer, 2010,116(6):1419-1430.

二级参考文献20

  • 1贺其图,时风桐,袁祖正.包头市白血病流行病学调查[J].内蒙古医学杂志,1993,13(2):3-5. 被引量:10
  • 2江倩,陈珊珊,江滨,江浩,丘镜滢,刘艳荣,张艳,秦亚溱,陆颖,黄晓军,陆道培.甲磺酸伊马替尼治疗慢性粒细胞白血病慢性期100例追踪观察[J].中华血液学杂志,2006,27(11):721-726. 被引量:39
  • 3North American Association of Central Cancer Registries (2007) North American age-specific invasive cancer incidence rates, chronic myeloid leukemia,2000-2004, http ://www. cancer-rates, info/ naaccr/.
  • 4Laneuville P, Barnett M J, Belanger R, et al. Recommendations of the Canadian consensus group on the management of chronic myeloid leukemia. Curr Oncol,2006,13:201-221.
  • 5O ' Brien SG, Guilhot F, Goldman JM, et al. International randomized study of interferon versus STI571 (IRIS) 7-year follow-up: sustained survival ,low rate of transformation and increased rate of major molecular response(MMR) in patients with newly diagnosed chronic myeloid leukemia in chronic phase(CML-CP) treated with imatinib(IM). Blood ,2008,112 : 186a.
  • 6Patel H,Marley SB,Gordon MY.Detection in primary chronic myeloid leukaemia cells of P210BCR-ABL1 in complexes with adaptor proteins CBL,CRKL,and GRB2.Genes Chromosomes Cancer,2006,45:1121-1129.
  • 7Hamilton A,Elrick L,Myssina S,et al.BCR/ABL activity and its response to drugs can be determined in CD34+ CML stem cells by CRKL phosphorylation status using flow cytometry.Leukemia,2006,20:1035-1039.
  • 8Livak KJ,Schmittgen TD.Analysis of relative gene expression data using real-time quantitative PCR and the Method 2-△△Ct method.Methods,2001,25:402-408.
  • 9Oda T,Heaney C,Hagopian JR,et al.CRKL is the major tyrosine-phosphorylated protein in neutrophils from patients with chronic myelogenous leukemia.J Biol Chem,1994,269:22925-22928.
  • 10Nichols GL,Raines MA,Vera JC,et al.Identification of CRKL as the constitutively phosphorylated 39-kD tyrosine phosphoprotein in chronic myelogenous leukemia cells.Blood,1994,84:2912-2918.

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  • 1Gold JS, van der Zwan SM, Gonen M, et al. Outcome of metastatic GIST in the era before tyrosine kinase inhibitors [J]. Ann Surg Oncol,2007,14 ( 1 ) : 134-142.
  • 2Casali PG, Jost L, Reichardt P, et al. Gastrointestinal stromal tumours: ESMO clinical recommendations for diagnosis, treatment and follow-up [ J]. Ann Oncol,2009, Suppl 4:64-67.
  • 3Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1 ) [J]. Eur J Cancer,2009,45(2) :228-247.
  • 4National Institutes of Health. Common Terminology Criteria for Adverse Events Verson 3.0 [EB/OL].2003 [ 2011-11-10]. http ://etep. cancer, gov/protocolDevelopment/electronic_ applications/ctc, htm.
  • 5DeMatteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival [ J]. Ann Surg,2000,231 (1) :51-58.
  • 6Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c - kit in human gastrointestinal stromal tumors [ J ]. Science, 1998,279 (5350) :577-580.
  • 7Verweij J, Casali PG, Zalcberg J, et al. Progression- free survival in gastrointestinal stromal tumours with high - dose imatinib: randomised trial [ J ]. Lancet,2004,364 ( 9440 ) : 1127-1134.
  • 8Zalcberg JR,Verweij J, Casali PG, et al. Outcome of patients with advanced gastro-intestinal stromal tumours crossing over to a daily imatinib dose of 800 mg after progression on 400 mg [J]. Eur J Cancer,41 (12) :1751-1757.
  • 9Gastrointestinal Stromal Tumor Meta-Analysis Group (MetaGIST). Comparison of two doses of imatinib for the treatment of unresectable or metastatic gastrointestinal stromal tumors : a meta- analysis of 1,640 patients [ J]. J Clin Oncol,2010,28 (7) :1247- 1253.
  • 10Demetri GD,van Oosterom AT, Garrett CR, et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib : a randomised controlled trial [ J ]. Lancet, 2006,368 ( 9544 ) : 1329 -1338.

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