基层医院干扰素α-2b联合高三尖杉酯碱治疗慢性粒细胞白血病的效果观察

Interferon α-2b combined with homoharringtonine alkali in treatment of chronic myeloid leukemia at primary hospital

目的评价基层医院干扰素α-2b联合高三尖杉酯碱治疗慢性粒细胞白血病的临床效果及不良反应。方法选择本院2003年1月至2011年3月已确诊为慢性粒细胞白血病的患者80例作为研究对象，分为观察组（45例）和对照组（35例）。对照组采用干扰素α-2b治疗，观察组采用干扰素α-2b联合高三尖杉酯碱治疗，对比两组临床治疗效果。结果观察组治疗3个月血液学缓解有效率为71.11%，明显高于对照组的54.29%，差异有统计学意义（P〈0.05）；观察组治疗6个月部分细胞遗传学缓解率（80.00%）、12个月完全细胞遗传学缓解率（71.11%）、18个月主要分子学缓解率（64.44%）与对照组（48.57%、42.86%、0.00%）比较，差异具有统计学意义（均P〈 0.05）。观察组不良反应较轻，安全性要高于对照组，差异具有统计学意义（P〈0.05）。观察组5年总生存率为86.67%，无事件生存率为73.33%，与对照组的60.00%、45.71%比较，差异具有统计学意义（均P〈0.05）;观察组不良反应发生率明显低于对照组，差异具有统计学意义（χ2=4.024，P〈0.05）。结论干扰素α-2b联合高三尖杉酯碱治疗慢性粒细胞白血病患者能明显提高临床疗效，且不良反应少，可延长无疾病进展生存期。

Objective To evaluate the clinical effect and adverse reactions of interferon ct-2b combined with homoharringtonine alkali in the treatment of chronic myeloid leukemia at primary hospital. Methods 80 patients diagnosed with chronic myelogenous leukemia at our hospital from January, 2003 to March, 2011 were selected as study objects and were divided into an observation group （45 cases） and a control group （35 cases）. The control group was treated with interferon α-2b and the observation group with interferon α-2b and homoharringtonine alkali. The clinical outcomes were compared between these two groups. Results After 3 months＇ treatment, the hematologic response rate was 71.11% in the observation group and 54.29% in the control group, with a statistical difference （P 〈 0.05）. The partial cytogenetic response rates 6, 12, and 18 months after treatment were 80.00%, 71.11%, and 64.44% in the observation group and were 48.57%, 42.86%, and 0.00% in the control group, with statistical differences （all P 〈 0.05）. The adverse reactions were milder in the observation group than in the control group, so the treatment for the observation group was safer than that for the contro! group （P 〈 0.05）. The total five-year survival rate was 86.67% and event-free survival rate 73.33% in the observation group and 60.00% and 45.71% in the control group, with statistical differences （all P 〈 0.05）. The incidence of adverse reactions was significantly lower in the observation group than in the control group, with a statistical difference （χ2= 4.024, P 〈 0.05）. Conclusions Interferon α-2b combined with homoharringtonine alkali for patients with chronic myeloid leukemia can significantly increase the clinical efficacy, has few adverse reactions, and can prolong progression-free survival period.