达沙替尼与伊马替尼治疗慢性粒细胞白血病慢性期患者效果的Meta分析

Meta-analysis of efficacies of dasatinib and imatinib for patients with chronic myeloid leukemiachronic phase

目的比较达沙替尼和伊马替尼治疗慢性粒细胞白血病慢性期（CML—CP）患者的效果。方法通过计算机检索Cochrane图书馆、OVID数据库、Embase数据库、PubMed数据库、中国期刊全文数据库（CNKI）、SpringerLink数据库、万方数据库、维普数据库，并进一步对纳入文献的参考文献扩大检索。对纳入的随机对照研究采用Cochrane风险偏倚评估工具进行质量评价。采用RevMan5．1软件进行统计学分析。结果共纳入5篇文献，CML—CP患者2031例。Meta分析结果显示，达沙替尼组12个月完全细胞遗传学反应（CCyR）率高于伊马替尼组[83．6％（478／572）比70．6％（406／575），合并比值比（OR）=2．11，95％CI1．59～2．80，P〈0．05]；达沙替尼组12个月主要分子生物学反应（MMR）率高于伊马替尼组[49．3％（296／600）比30．6％（185／605），OR=2．22，95％CI1．75～2．82，P〈0．05]。结论达沙替尼可以提高CML—CP患者12个月的CCyR率和MMR率。

Objective To compare the efficiencies of imatinib and dasatinib in patients with chronic myeloid leukemia-chronic phase （CML-CP）. Methods The databases were retrieved, ineluding Cochrane Library, OVID, Embase, PubMed, China National Knowledge Infrastructure （CNKI）, WanFang database and VIP database, besides, references of articles were further to search. The quality of randomized controlled trials （RCTs） was assessed by the Cochrane collaboration＇s risk tool. Meta-analysis was performed by RevMan 5.1 software. Results A total of 5 articles involved 2 031 patients with CML-CP were included. Meta-analysis showed that the rate of complete cytogenetic response （CCyR） at the 12th month in dasatinib group was higher than that in imatinib group [83.6 % （478/572） vs 70.6 % （406/575）, OR = 2.11, 95 % CI 1.59-2.80, P 〈 0.05], and the rate of major molecular response （MMR） at the 12th month in dasatinib group was higher than that in imatinib group [49.3 % （296/600） vs 30.6 % （185/605）, OR = 2.22, 95 % CI 1.75-2.82, P 〈 0.05]. Conclusion Dasatinib can improve CCyR and MMR rate at the 12th month in CML-CP patients.