慢性粒细胞白血病远期疗效的观察

Observation of long-term therapeutic outcome in chronic granulocytic leukemia

目的 探讨不同方案治疗慢性粒细胞白血病 (CGL)的远期疗效。方法 回顾性地分析331例CGL患者的治疗随访情况 ,对不同治疗组中位慢性期、生存期及疾病转变情况进行分析。结果 甲异靛作缓解后治疗者中位慢性期及生存期长于以白消安作缓解后治疗者 ,10 0个月转恶率低于后者 ;单独应用甲异靛治疗组与单独应用羟基脲治疗组中位慢性期、生存期及 6 0 ,10 0个月转恶率差异无统计学意义 ,二者远期疗效均优于单独应用白消安治疗组 ;联合化疗组从中位慢性期、生存期及 6 0 ,10 0个月转恶率看疗效并不优于甲异靛、白消安及羟基脲治疗组 ;干扰素治疗组中位慢性期及生存期较常规化疗组明显延长 ,6 0 ,10 0个月转恶率明显低于常规化疗组。结论 白消安不宜用于缓解后的治疗 ,维持治疗方案以甲异靛或甲异靛联合羟基脲为佳 ;羟基脲联用甲异靛可提高疗效 ;干扰素有助于延长CGL患者慢性期及生存期 ,延缓急变的发生。

Objective To analyse the long term outcome of various therapeutic protocol for the treatment of chronic granulocytic leukemia(CGL). Methods Median duration of chronic phase, survival and transformation of 331 CGL patients treated with different project were retrospectively analyzed. Result Longer chronic phase and survival and lower percentage of transformation were found in patients using mesoindigo as maintaining treatment as compared with those using busulfan as maintaining treatment. The effect of meisoindigo and hydroxyurea showed no significant difference. These two drugs were both superior to bulsufan. Combination chemotherapy was not superior to meisoindigo, hydroxyurea or busulfan alone. Interferon had the best therapeutic effectiveness for the treatment of CGL. Conclusion Busulfan was not suitable for maintaining treatment. Meisoindigo or meisoindigo combined with hydroxyurea was good choices for maintaining treatment. Meisoindigo and hydroxyurea had better effect in combination than alone. Interferon could significantly prolong the chronic period and survival period of CGL patients.