新诊断慢性髓系白血病慢性期患者应用达沙替尼、尼洛替尼与伊马替尼治疗的效果评价

New diagnosis of chronic myeloid leukemia effect evaluation of chronic phase patients with dasatinib,nilotinib and imatinib treatment

目的分析达沙替尼、尼洛替尼与伊马替尼对慢性髓系白血病(CML)慢性期患者的治疗效果。方法选取2012年8月至2015年8月收治的96例新诊断慢性髓系白血病慢性期的患者按照数字表法随机分为3组,每组32例。三组患者分别接受达沙替尼(100 mg)、尼洛替尼(300 mg)和伊马替尼(400 mg)的治疗并进行随访,根据随访结果评价各药物的治疗效果及出现的不良反应。结果三组患者经过不同药物治疗后,完全血液缓解率和血细胞减少无明显差异;达沙替尼组和尼洛替尼组的完全细胞遗传缓解率(70.84%)、(71.88%)和主要分析学缓解率(37.50%)(36.46%)明显高于伊马替尼组(45.83%)(11.46%),且伊马替尼组不良反应的总发生率(81.25%)明显高于达沙替尼组(56.25%)和尼洛替尼组(53.14%),差异具有统计学意义(P<0.05)。结论慢性髓系白血病慢性期患者使用达沙替尼和尼洛替尼效果显著;不仅可以有效缓解症状,延缓病情发展,且不良反应轻,能更好地促进患者的康复。

Objective To analyze therapeutic effect of dasatinib,nilotinib and imatinib on chronic myeloid leukemia（ CML） in chronic phase patients. Methods We selected in our hospital from August 2012 to 2015 August 96 cases of chronic myeloid leukemia in chronic phase patients in accordance with the digital meter. All these patients were randomly divided into 3 groups,32 cases in each group,three groups of patients received dasatinib（ 100 mg qd）,nilotinib（ 300 mg bid） and imatinib（ 400 mg qd） and follow- up. According to the follow- up results,the therapeutic effect of the drug and adverse reactions were evaluated. Results Three groups of patients after different drug treatment,complete haematological remission rate and blood cells reduced did not show significant difference in dasatinib group and nilotinib group. The complete cytogenetic remission rate of the two groups were 70. 84% and 71. 88%,and mainly analysis remission rate were 37. 50%,36. 46%,which were significantly higher than those of imatinib group（ 45. 83%）（ 11. 46%）,and the adverse reaction incidence rate（ 81. 25%） of imatinib was significantly higher than dasatinib group（ 56. 25%） and nilotinib group（ 53. 14%） group,with significant difference（ P〈0. 05）. Conclusion Patients with chronic phase chronic myeloid leukemia with dasatinib and nilotinib effect not only can effectively relieve symptoms and delay the progression of the disease,and the adverse reactions are mild,promote the patient＇s recovery.