高三尖杉酯碱联合伊马替尼治疗非Abl-T315I突变进展期慢性髓细胞白血病的临床疗效

Effect of homoharringtonine on Non-Abl-T315I Mutation in progressive chronic myeloid leukemia

目的探讨高三尖杉酯碱治疗非Abl-T315I突变进展期慢性髓细胞白血病(CML)的临床疗效。方法选取榆林市第二医院自2014年2月-2017年2月收治的非T315I突变进展期CML患者65例作为研究对象,按照双盲随机原则分成两组,对照组患者32例使用伊马替尼治疗,观察组患者33例在对照组基础上加用高三尖杉酯碱治疗,持续滴注7~11 d为1个治疗周期,每个月治疗1个周期,直至血液学指标缓解。对比两组患者治疗后细胞遗传学变化和血液学改变情况,记录两组患者毒副反应发生率情况。结果两组患者治疗后血液学指标缓解率差异无统计学意义,观察组患者治疗12个月时遗传细胞学完全缓解率优于对照组,差异有统计学意义(P<0.05)。两组患者毒副作用差异无统计学意义。结论高三尖杉酯碱的毒性小,对CML患者而言长期使用对血液学毒副作用较小,同时能够提升CML患者个细胞遗传学的缓解率,值得推广使用。

Objective To investigate the clinical efficacy of high concentration of lanceoline in the treatment of non Abl mutation positive(T315 I) advanced chronic myeloid leukemia(CML).Methods 65 cases of non T215 I progressive CML patients admitted in our hospital from February 2014 to February 2017 were selected as the research object,divided into two groups according to the double blind random principle,32 cases in the control group were treated with imatinib,and 33 cases of the observation group were treated with high APU fir base on the basis of the control group,and the treatment of the two groups was compared.Cytogenetic changes and hematological changes were recorded,and the incidence of adverse reactions in the two groups was recorded.Results There was no significant difference in the rate of hematological remission between the two groups.The rate of remission of genetic cytology in the observation group was better than that of the control group at 12 months(P<0.05),and there was no significant difference in the side effects between the two groups.Conclusion The toxicity of high perlullapine is small and it has less side effects on hematology for CML patients.It can also improve the rate of cytogenetics in CML patients.It is worth popularizing.