尼洛替尼治疗慢性粒细胞白血病临床观察及药品不良反应与UGT UGT1A1基因多态性相关性分析

Clinical Observation of Nilotinib in the Treatment of Chronic Myeloid Leukemia and Correlation Analysis Between Nilotinib Adverse Reactions and UGT1A1 Gene Polymorphism

目的探讨尼洛替尼治疗慢性粒细胞白血病(CML)的临床疗效,以及药品不良反应与UGT1A1基因多态性的相关性。方法选取医院2020年9月至2023年8月收治的13例伊马替尼耐药或不耐受CML患者为研究对象,均接受尼洛替尼治疗,观察临床疗效及药品不良反应与UGT1A1基因多态性的相关性。结果与治疗前比较,患者治疗后的血液学、分子生物学的整体疗效显著(P<0.05);且治疗后的毒性反应发生率更低(P<0.05)。患者存在4种UGT1A1基因表型,分别为UGT1A1*6 GG、UGT1A1*6 GA、UGT1A1*286/6 TA、UGT1A1*286/7 TA,UGT1A1*28基因表型为6/7 TA的患者更易出现严重的不良反应。结论在伊马替尼耐药或不耐受CML治疗过程中应用尼洛替尼,能改善患者血液学、分子生物学疗效,大幅降低毒性反应。尼洛替尼不良反应与UGT1A1基因多态性相关,对UGT1A1型28基型表型患者应更密切关注其不良反应。。

Objective To investigate the clinical observation of nilotinib in the treatment of chronic myeloid leukemia(CML),and the correlation between nilotinib adverse reactions and UGT1A1 gene polymorphism.Methods Thirteen patients with imatinib resistant or intolerant CML admitted to the hospital from September 2020 to August 2023 were selected as the study subjects,all of whom received nilotinib treatment.The efficacy and the correlation between drug adverse reactions and UGT1A1 gene polymorphism were observed.Results Compared with those before treatment,the overall therapeutic effect of hematology and molecular biology in patients after treatment was significant(P<0.05);the incidence of toxic reactions after treatment was lower(P<0.05).There was UGT1A1 gene polymorphism in CML patients taking nilotinib,with four gene phenotypes,namely UGT1A1*6 GG UGT1A1*6 GA,UGT1A1*286/6 TA,and UGT1A1*286/7 TA.Conclusion Nilotinib in the treatment of imatinib resistant or intolerant CML can improve the hematological and molecular biology treatment of patients and significantly reduce toxic reactions.The adverse reactions of nilotinib are associated with UGT1A1 gene polymorphism,and patients with UGT1A1*28 gene phenotype of 6/7 TA are more likely to experience severe adverse reactions.