伊马替尼治疗慢性髓性白血病后6个月的分子学反应的预后意义

Predictive value of molecular response at 6 months in patients with chronic myeloid leukemia treated with imatinib

目的 :探讨伊马替尼治疗慢性髓性白血病(chronic myelocytic leukemia,CML)6个月时分子学反应(BCR-ABL<1%)在疗效监测中的意义。方法:38例初诊慢性期CML患者,计算Sokal积分,分析伊马替尼治疗前及治疗后3、6、9、12、18、24个月时的染色体和BCR-ABL表达。结果:CML患者的Sokal危险度分级与早期分子学反应无明显相关性;在6个月时BCR-ABL<1%患者较BCR-ABL≥1%患者有更高的完全细胞遗传学缓解(CCy R)和主要分子生物学缓解(MMR),差异有统计学意义(P<0.05)。结论:慢性髓性白血病伊马替尼治疗后6个月的BCR-ABL<1%预示患者良好的预后,推测可以作为早期临床干预的依据之一。

Objective:To explore the prognostic value of monitoring BCR-ABL transcripts at 6 months in patients with chronic myeloid leukemia in chronic phase(CML-CP)treated with imatinib.Methods:Total 38 patients with CML-CP receiving imatinib as first line therapy were involed,Sokal scores were evaluated before treatment,karyotypic analysis and BCR-ABL level detection by real-time quantitative polymerase chain reaction(RQ-PCR)were carried out before and after the treatment of 3,6,9,12,18,24 months.Results:There were no significant correlation between Sokal risk classification and molecular response at 6 months after imatinib treatment.The results showed that the Complete cytogenetic response(CCyR)and Major molecular response(MMR)of patients with low BCR-ABL transcriptional levels(BCR-ABL<1%)was significantly superior to that with high BCR-ABL transcriptional levels(BCR-ABL≥1%)for CML after 6 months’treatment(P<0.05).Conclusion:The BCR-ABL transcriptional levels<1%in CML-CP after 6months treatment with imatinib can predict good outcome,and can be used as one of the basis of early clinical intervention.