慢性粒细胞白血病患者酪氨酸激酶抑制剂停药原因分析

Motivation of Chinese patients with chronic myelogenous leukemia who have stopped the tyrosine kinase inhibitor

目的 分析慢性粒细胞白血病（CML）患者酪氨酸激酶抑制剂（TKI）停药的原因,并观察是否与其停药结局具有相关性.方法 遵患者知情同意,对47例CML TKI停药患者停药原因进行登记,观察24个月后将其分为复发组与非复发组,分析两组患者复发原因并进行统计学分析.结果47例TKI停药患者的主要停药原因为经费困难[59.57 %（28/47）]、计划妊娠[8.52 %（4/47）]、药物不良反应[23.40 %（11/47）]以及其他因素[8.52 %（4/47）].截至观察终点,23例患者临床复发,其中因经费困难15例（65.22 %）,药物不良反应5例（21.74 %）,其他因素2例（8.69 %）,计划妊娠1例（4.35 %）.结论 CML患者TKI停药可能影响治疗结局,主要与有无减药、停药史密切相关.

Objective To analyze the motivation of Chinese patients with chronic myelogenous leukemia （CML） who have stopped the tyrosine kinase inhibitor （TKI）. Methods Forty-seven CML patients who have stopped TKI provided informed consent prior to their participation in the study. These patients were divided into relapse and non-relapse group at the endpoint of the observation. None of the patients received any CML-associated therapies after TKI cessation. The reasons of withdrawal were analyzed statistically. Results The reasons for cessation included patient＆#39;s request due to cost（59.57 %, 28/47）, patient＆#39;s plan to getting pregnant（8.52 %,4/47）,side-effect of TKI（23.40 %,11/47）and other reasons（8.52 %,4/47）.At the endpoint of observation, 23 patients suffered molecular relapse. Among them, 15 cases （65.22 %） were due to cost; 1 case （4.35 %） was due to getting pregnant, 5 cases （21.74 %） were due to side-effect and 2 cases （8.69 %） were due to other reasons. There was more frequency relapse in the group of insufficient cost. Conclusion The motivation of Chinese CML patients who have stopped TKI might show impact on the outcome,and the motivation is mainly related with history of drug reduction and withdrawal.