达沙替尼治疗慢性髓系白血病1例

A case of chronic myeloid leukemia treated with dasatinib

1病例资料患者,女,24岁,因确诊慢性髓系白血病（chronic myeloid leukemia,CML）12年,于2014年2月来我院门诊就诊。患者2002年12月23日因眩晕、恶心、呕吐就诊于内蒙通辽某医院儿科,经血液学、骨髓及染色体检查,确诊为CML慢性期,后给予羟基脲间断口服治疗,2004-2007年改用干扰素（300万单位/次）皮下注射,隔天1次。

A female patient of chronic myeloid leukemia（CML）was early treated by chemotherapy（hydroxyurea,etc）and interferon from December 2002 to the time of achieving hematologic remission.In September 2011 hematologic relapse occured,she received imatinib 400mg/d for half a year and then imatinib 300mg/d due to side effects.But the real-time quantitative PCR result of BCR/ABL was still not negative after one year and an increase of bone marrow blasts was observed in February 2014.So the patient was given dasatinib every day and100 mg once a day.After 3 months,the patient achieved hematologic complete remission（HCR）,and real-time quantitative PCR showed BCR/ABL（P210）negative with copy number〈0.000 1%,in line with the criteria for molecular biology remission.After continued medication,repeatedly monitoring of blood showed liver and kidney functions normal with normal size of liver and spleen,and the patient remained in HCR and molecular remission after 18 months.The results show that dasatinib can quickly help to reach HCR and molecular remission in patient of CML who used imatinib but invalid.Periodic review of BCR-ABL copy number during treatment of CML and dose adjustment according to changes in a timely manner is essential.