河北医学2017，Vol.23Issue(10)：1591-1594,4.DOI:10.3969/j.issn.1006-6233.2017.10.003
二代酪氨酸激酶抑制剂一线二线治疗慢性髓细胞白血病的临床研究
Clinical Study on Second-generation Tyrosine Kinase Inhibitors in the First-line and Second-line Treatment of Chronic Myeloid Leukemia
摘要
Abstract
Objective:To investigate the clinical effect of second-generation tyrosine kinase inhibitors in the treatment of chronic myeloid leukemia ( CML) . Methods:A total of 64 patients with CML treated between January 2013 and December 2016 were selected as study subjects and treated with second-generation tyrosinekinase inhibitor ( TKI) . Among them,there were 41 cases treated with Nilotinib and 23 cases with Dasatinib. In patients treated by TKI,there were 13 cases receiving first-line medication and 51 cases receiving second-line medication. All were followed up for 6 ~ 54 months,median 18 months. The overall complete hematologic remission ( CHR) rate,CCyR rate,rate of major cytogenetic response ( MCyR),MMR rate,follow-up over-all survival rate ( OS) and event free survival rate ( EFS) were observed;Meanwhile,the responses of first-line and second-line treatment and adverse drug reactions were compared. Results:At the end of follow-up,43 cases continued second-generation TKI treatment, 14 cases died, 2 cases stopped medication, 2 cases were lost to follow up and 3 cases changed the medication regimen;In terms of overall responses to treatment,the rates of CHR, MCyR, CCyR and MMR were 98. 44%, 64. 00%, 59. 37% and 43. 75% respectively; In terms of overall survival status,OS and EFS decreased with duration of the disease. The rates of CCyR,MCyR and MMR of first-line treatment were significantly higher than the second-line treatment ( P < 0.05);There were no significant differences in the incidence of adverse drug reactions between Nilotinib and Dasatinib ( P >0.05) . Conclusion:The effect of Nilotinib and Dasatinib second-generation TKI in the treatment of CML is clear. The prognosis is good and safety is better; The effect of second generation TKI first-line treatment is better than second-line treatment in treating CML.关键词
慢性髓细胞白血病/二代络氨酸激酶抑制剂/临床疗效Key words
Chronic myeloid leukemia/Second-generation tyrosine kinase inhibitors/Clinical effect引用本文复制引用
陈亨,蒋元强,沈云峰,陆米则,王菱菱,庄芸,杨国华..二代酪氨酸激酶抑制剂一线二线治疗慢性髓细胞白血病的临床研究[J].河北医学,2017,23(10):1591-1594,4.基金项目
江苏省卫生厅资助基金项目,(编号:20130105) （编号:20130105）
