The acquisition of secondary chromosomal aberrations in chronic myeloid leukemia (CML) patients with Philadelphia chromosome-positive (Ph+) karyotype signifies clonal evolution associated with the progression of the d...The acquisition of secondary chromosomal aberrations in chronic myeloid leukemia (CML) patients with Philadelphia chromosome-positive (Ph+) karyotype signifies clonal evolution associated with the progression of the disease to its accelerated or blastic phase. Therefore, these aberrations have clinical and biological significance. T(3;12)(q26;p13), which is a recurrent chromosomal aberration observed in myeloid malignancies, is typically associated with dysplasia of megakaryocytes, multilineage involvement, short duration of any blastic phase, and extremely poor prognosis. We have identified a recurrent reciprocal translocation between chromosomes 3 and 12 with different breakpoint at bands 3q21 in the malignant cells from a 28-year-old man. The patient was initially diagnosed as having Ph+ CML in the chronic phase. The t(3;12)(q21;p13) translocation occurred 4 years after the patient was first diagnosed with CML while undergoing tyrosine kinase inhibitor therapy. We confirmed the t(3;12)(q21;p13) translocation via fluorescence in situ hybridization assay by using whole-chromosome paint probes for chromosomes 3 and 12. Our findings demonstrate that, similar to other recurrent translocations involving 3q26 such as t(3;3) and t(3;21), the t(3;12)(q21;p13) translocation is implicated not only in myelodysplastic syndrome and acute myeloid leukemia but also in the progression of CML. These findings extend the disease spectrum of this cytogenetic aberration.展开更多
The study was conducted to explore the effect of imatinib,nilotinib,and dasatinib in the treatment of chronic myeloid leukemia(CML)patients.Around 66 patients with CML in chronic phase were selected,subsequently the p...The study was conducted to explore the effect of imatinib,nilotinib,and dasatinib in the treatment of chronic myeloid leukemia(CML)patients.Around 66 patients with CML in chronic phase were selected,subsequently the patients were subdivided into 3 groups with 22 patients in each group:Group A were treated with imatinib;Group B were treated with nilotinib;and Group C were treated with dasatinib.The study showed that,at 18 months of treatment,compared with group A,the molecular biology remission rates of group B and group C were significantly higher,p<0.05;at 6 months and 18 months of treatment,compared with group A,the complete cytogenetic remission rates of group B and group C were significantly higher,p<0.05;and compared with group A,the incidences of vomiting,headache and edema in groups B and C were significantly lower,p<0.05.However,no significant different p>0.05 were observed in the complete hematologic remission rates,and the incidences of neutropenia and thrombocytopenia among the three groups.In summary,nilotinib and dasatinib are effective in the treatment of patients with CML in the chronic phase,which is significantly better than imatinib treatment.展开更多
目的探讨格列卫在1例慢性粒细胞性白血病慢性期的患者的最佳应用方案.方法计算机检索ACP Journal Club (1991～2005年4月)、Cochrane图书馆(2005年第2期)和MEDLINE(1990～2005年4月),收集格列卫治疗慢性粒细胞白血病慢性期的系统评价、...目的探讨格列卫在1例慢性粒细胞性白血病慢性期的患者的最佳应用方案.方法计算机检索ACP Journal Club (1991～2005年4月)、Cochrane图书馆(2005年第2期)和MEDLINE(1990～2005年4月),收集格列卫治疗慢性粒细胞白血病慢性期的系统评价、临床随机对照试验、卫生经济学评价等,并对所获证据质量进行评价.结果高质量的临床证据表明:在血液学和细胞遗传学缓解率以及生存质量方面,格列卫均优于传统疗法,且副作用相对较少.结合我们的临床经验,并考虑患者及其家属的意愿,最后为患者制定治疗方案为格列卫400 mg qd,随访3个月血液指标学完全缓解,ph染色体1/30(+),达到主要细胞遗传学缓解,且无明显不良反应发生.结论格列卫是治疗慢性粒细胞性白血病慢性期的有效药物,可作为临床一线用药.但其长期疗效和不良反应以及经济学评价仍有待进一步研究.展开更多
文摘The acquisition of secondary chromosomal aberrations in chronic myeloid leukemia (CML) patients with Philadelphia chromosome-positive (Ph+) karyotype signifies clonal evolution associated with the progression of the disease to its accelerated or blastic phase. Therefore, these aberrations have clinical and biological significance. T(3;12)(q26;p13), which is a recurrent chromosomal aberration observed in myeloid malignancies, is typically associated with dysplasia of megakaryocytes, multilineage involvement, short duration of any blastic phase, and extremely poor prognosis. We have identified a recurrent reciprocal translocation between chromosomes 3 and 12 with different breakpoint at bands 3q21 in the malignant cells from a 28-year-old man. The patient was initially diagnosed as having Ph+ CML in the chronic phase. The t(3;12)(q21;p13) translocation occurred 4 years after the patient was first diagnosed with CML while undergoing tyrosine kinase inhibitor therapy. We confirmed the t(3;12)(q21;p13) translocation via fluorescence in situ hybridization assay by using whole-chromosome paint probes for chromosomes 3 and 12. Our findings demonstrate that, similar to other recurrent translocations involving 3q26 such as t(3;3) and t(3;21), the t(3;12)(q21;p13) translocation is implicated not only in myelodysplastic syndrome and acute myeloid leukemia but also in the progression of CML. These findings extend the disease spectrum of this cytogenetic aberration.
文摘The study was conducted to explore the effect of imatinib,nilotinib,and dasatinib in the treatment of chronic myeloid leukemia(CML)patients.Around 66 patients with CML in chronic phase were selected,subsequently the patients were subdivided into 3 groups with 22 patients in each group:Group A were treated with imatinib;Group B were treated with nilotinib;and Group C were treated with dasatinib.The study showed that,at 18 months of treatment,compared with group A,the molecular biology remission rates of group B and group C were significantly higher,p<0.05;at 6 months and 18 months of treatment,compared with group A,the complete cytogenetic remission rates of group B and group C were significantly higher,p<0.05;and compared with group A,the incidences of vomiting,headache and edema in groups B and C were significantly lower,p<0.05.However,no significant different p>0.05 were observed in the complete hematologic remission rates,and the incidences of neutropenia and thrombocytopenia among the three groups.In summary,nilotinib and dasatinib are effective in the treatment of patients with CML in the chronic phase,which is significantly better than imatinib treatment.
文摘目的:探讨酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)联合地西他滨、高三尖杉酯碱、干扰素方案在慢性髓性白血病急变期(blast phase chronic myeloid leukemia,CML-BP)患者缓解后维持治疗的疗效。方法:回顾性分析2015年6月至2021年12月就诊于郑州大学附属肿瘤医院经诱导治疗首次获得主要血液学反应的CML-BP患者的临床资料,采用log-rank检验比较TKI联合地西他滨、高三尖杉酯碱、干扰素组(n=18)与TKI联合传统化疗组(n=10)维持治疗患者的中位无事件生存时间、缓解持续时间和总生存时间。结果:共纳入28例患者,中位年龄46(24-58)岁。Kaplan-Meier生存分析显示,TKI联合地西他滨、高三尖杉酯碱、干扰素组较TKI联合传统化疗组的无事件中位生存时间(7.4 vs 4.3个月,P=0.043,HR=0.44,95%CI:0.17-1.14)、持续缓解中位时间(16.1 vs 6.6个月,P=0.005,HR=0.32,95%CI:0.11-0.89)及总生存中位时间(34.3 vs 13.5个月,P=0.006,HR=0.29,95%CI:0.10-0.82)均显著延长。结论:对于CML-BP且获得缓解的患者,TKI联合地西他滨、高三尖杉酯碱、干扰素方案较TKI联合传统化疗方案维持治疗可显著延长患者生存。
