摘要
目的研究阿糖胞苷联合格列卫治疗慢性髓系白血病ABL激酶区突变的临床疗效,同时对治疗预后进行分析。方法选取271例慢性髓系白血病ABL激酶区突变患者,根据用药情况分为格列卫组69例,阿糖胞苷组91例和联合组111例(格列卫联合阿糖胞苷);随访3组患者6个月和12个月时的完全血液学缓解(CHR)、细胞遗传学缓解(MCyR)、完全细胞遗传学缓解(CCyR)、分子生物学缓解(MMR)和完全分子生物学缓解(CMR)情况,同时观察3组患者12个月后的不良反应发生率、血液学复发率、分子遗传学复发率及细胞遗传学复发率,同时记录死亡情况和死亡时间等。结果联合组治疗6个月后CHR、MCyR、CCyR、MMR和CMR比例明显高于阿糖胞苷组、格列卫组,差异具有统计学意义(P<0.05);联合组随访12个月时血液学复发率、分子遗传学复发率及细胞遗传学复发率分别为1.80%、0.90%、0,明显低于阿糖胞苷组(8.79%、5.49%、2.19%)和格列卫组(10.14%、8.69%、0,P<0.05);联合组随访12个月时的不良反应总发生率为8.10%,显著低于格列卫组(21.73%)和阿糖胞苷组(16.48%),差异有统计学意义(P<0.05);联合组随访12个月时死亡率为1.80%,明显低于格列卫组(7.24%)和阿糖胞苷组(6.59%),差异有统计学意义(P<0.05)。结论格列卫联合阿糖胞苷能够明显提高慢性髓系白血病ABL激酶区突变患者的生存质量和生存率。
Objective To study the clinical efficacy of cytarabine combined with Gleevec in the treatment of ABL kinase region mutations in chronic myeloid leukemia(CML),and to analyze the prognosis of the treatment.Methods A total of 271 patients with CML ABL kinase region mutation were selected and divided into the Gleevec group(69 cases),cytarabine group(91 cases)and combination group(111 cases)(Gleevec combined with cytarabine)according to their medication status;the complete hematological remmision(CHR),cytogenetic remission(MCyR),complete cytogenetic remission(CCyR)amd molecular biological remission(MMR)and complete molecular biological remission(CMR)in 3 groups were followed up in 6 months and 12 months,meanwhile the incidence rates of adverse reactions,hematological recurrence rate,molecular genetic recurrence rate and cytogenetic recurrence rate were simultaneously observed after 12 months in the three groups,and the death and time of death were simultaneously recorded.Results The remission rates of CMR,MCyR,CHR,CCyR and MMR after 6 months in the combined group were significantly higher than those in the cytarabine group and Gleevec group,and the differences were statistically significant(P<0.05);the hematological recurrence rate,molecular genetic recurrence rate and cytogenetic recurrence rate fter 12 months follow up in the combined group were 1.80%,0.90%and 0,respectively,which were significantly lower than 8.79%,5.49%and 2.19%in the cytarabine group and 10.14%,8.69%and 0 in the Gleevec group(P<0.05);the total incidence rate of adverse reactions at 12-month follow-up in the combined group was 8.10%,which was significantly lower than 21.73%in the Gleevec group and 16.48%in the cytarabine group,and the differences were statistically significant(P<0.05);the mortality rate at 12 months of follow-up in the combined group was 1.80%,which was significantly lower than 7.24%in the Gleevec group and 6.59%in the cytarabine group(P<0.05).Conclusion Gleevec combined with cytarabine can significantly improve the quality of life of the patients with CML ABL kinase region mutation and improve their survival rate.
作者
杨欢
刘扬
陈相言
文明
刘徽
YANG Huan;LIU Yang;CHEN Xiangyan;WEN Ming;LIU Hui(Department of Rheumatism,Immunology and Hematology,Guang′an Municipal People′s Hospital,Guang′an,Sichuan 638000,China)
出处
《重庆医学》
CAS
2022年第10期1706-1709,共4页
Chongqing medicine
基金
四川省卫生和计划生育委员会科研项目(18PJ394)。
