达沙替尼引起的大颗粒淋巴细胞增多与慢性髓系白血病

The large granular lymphocytosis during dasatinib treatment and chronic myeloid leukemia

慢性髓系白血病（chronic myeloid leukemia,CML）是一种起源于造血干细胞的恶性骨髓增殖性疾病。其发病的分子基础是Ph染色体[t（9,22）（q34;q11）易位]产生BCR-ABL融合基因。而该基因编码具有酪氨酸激酶活性的融合蛋白,从而引发大量白血病细胞恶性增殖是其发病的根本原因（[1-2]）。

Dasatinib as the second generation of tyrosine kinase inhibitors for the first time in June 2006 was approved for imatinib resistance or intolerance with chronic myeloid leukemia（CML）patients.Recent clinical studies have reported that the lymphocyte counts increased in peripheral blood in some CML patients with dasatinib treatment,moreover the increased lymphocytes mainly focus on large granular lymphocytes.The CML patients with large granular lymphocytosis in peripheral blood may achieve higher molecular response,and the large granular lymphocytosis has been predicted to be a favorable therapeutic response for CML patients with BCR-ABL fusion gene positive.However,the precise mechanism of large granular lymphocytosis is not clear so far,and the continued researches of relationship between the large granular lymphocytosis and effect of treatment with dasatinib for CML patients have been needed.