伊马替尼、尼洛替尼和达沙替尼对慢性粒细胞白血病慢性期的临床分析

The Clinical Analyzing of Chronic Myeloid Leukemia in Chronic Phase by Imatinib,Nilotinib and Dasatinib

目的:探讨伊马替尼、尼洛替尼和达沙替尼对慢性粒细胞白血病慢性期的临床效果情况。方法:分析广东省化州市人民医院2013年2月-2016年2月收治的慢性粒细胞白血病患者78例临床资料,依据治疗药物不同进行分组,治疗Ⅰ组(伊马替尼治疗)22例,治疗Ⅱ组(尼洛替尼治疗)30例,治疗Ⅲ组(达沙替尼治疗)26例。观察三组慢性粒细胞白血病患者不同时间点完全细胞遗传缓解率(CCyR)、完全血液学缓解率(CHR)、分子生物学缓解率(MMR)、不良反应情况。结果:三组患者CHR比较,差异均无统计学意义(P>0.05)。治疗18个月时,治疗Ⅱ组、治疗Ⅲ组患者MMR均高于治疗Ⅰ组,差异均有统计学意义(P<0.05);治疗6、18个月时,治疗Ⅱ组、治疗Ⅲ组患者CCyR均高于治疗Ⅰ组,差异均有统计学意义(P<0.05);治疗Ⅱ组、治疗Ⅲ组患者头痛、呕吐、水肿发生率均低于治疗Ⅰ组,差异均有统计学意义(P<0.05);三组患者血小板减少症、嗜中性粒细胞减少发生率比较,差异无统计学意义(P>0.05)。结论:尼洛替尼和达沙替尼治疗慢性粒细胞白血病患者,CCyR和MMR改善效果更加明显,值得临床推广应用。

Objective:To approach clinical result of chronic myeloid leukemia in chronic phase by Imatinib,Nilotinib and Dasatinib.Method:The 78 cases clinical data of chronic myeloid leukemia in the people hospital Guangdong province Huazhou city from February 2013 to February 2016 were analyzed,the patients were divided into three groups by different treatment drug,treatment group Ⅰ(22 cases,Imatinib treatment),treatment group Ⅱ(30 cases,Nilotinib treatment) and treatment group Ⅲ(26 cases,Dasatinib treatment).The CCyR,CHR,MMR,adverse reactions of three group chronic myeloid leukemia in different time were detected.Result:The CHR of three group were compared,the differences were no statistical significance(P>0.05);at treatment of 18 months, the MMR of treatment group Ⅱ,treatment group Ⅲ were higher than treatment group Ⅰ,the differences were statistically significant(P<0.05).At 6 and 18 months of treatment,CCyR of treatment group Ⅱ and treatment group Ⅲ were higher than those of treatment group Ⅰ,with statistical significance(P<0.05).The headache,vomit,edema rate of treatment group Ⅱ,treatment group Ⅲ patients were lower than those of treatment group Ⅰ,the differences were statistical significant(P<0.05).The thrombocytopenia,neutrophils rate of three group patients were compared,the differences were no statistical significance(P>0.05). Conclusion:The chronic myeloid leukemia patients by Nilotinib and Dasatinib,improving result of CCyR and MMR is obviously,it is worth to be used.