摘要
目的:动态观察甲磺酸伊马替尼(商品名:格列卫)在2例加速期BCRABL阳性的慢性粒细胞白血病(CML)患者异基因外周血造血干细胞移植(AlloPBSCT)前的应用。方法:应用PCR技术,对接受甲磺酸伊马替尼的BCRABL阳性的CML患者选择不同时间定性检测bcr/abl基因,同时进行骨髓形态学及染色体分析。结果:①甲磺酸伊马替尼治疗1个月后2例均达到血液学完全缓解,病例2达到细胞遗传学完全缓解;②移植后中性粒细胞>0.5×109/L,血小板>20×109/L病例1为13d,病例2为20d;③病例1于+32d血型转为供者型,病例2于+40d供受细胞稳定嵌合,目前2例患者血液学持续完全缓解。结论:化疗可以动员G0期bcr/abl阳性克隆进入增殖周期,表现对甲磺酸伊马替尼敏感,在CML尤其是进入加速期、急变期的患者行PBSCT前应用甲磺酸伊马替尼,有助于体内的bcr/abl白血病细胞清除,达到肿瘤净化作用。
Objective:To observe the application of STI571 in patients with accelerated phase of chronic myelocytic leukemia treated before allogeneic peripheral blood stem cell transplantation.Method:bcr/abl gene were examined in patients with CML treated with STI571 at the different time points by means of the qualitative reverse transcription polymerase chain reaction (RT-PCR) technique, and the bone morphology and chromosome were analysised simultaneously.Result:①Before Allo-PBSCT, two patients were treated with STI571, and two cases obtained complete hematopoietic remission and one of them obtained complete cytogenetic remission. ②After transplanstation, neutrophil cell> 0.5×10 9/L, platelet>20×10 9/L in two cases were 13 day and 20 day. ③The blood type of one case changed to donor's in +32 day, the other case had stable engraftment and donor chimerism in +40 day.Conclusion:Bcr/abl positive primitive stem cells in G0 phrase may go into cell cycle after chemotherapy and the cells in cell cycle were sensitive to STI571. It is helpful to purge the bcr/abl positive leukemia cells when CML patients, especially those in accelerated phase and blast crisis are treated with STI571 before PBSCT.
出处
《临床血液学杂志》
CAS
2005年第3期154-155,158,共3页
Journal of Clinical Hematology
