Department of Hematology and Oncology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa 920-8641, Japan.
Int J Hematol. 2012 Sep;96(3):357-63. doi: 10.1007/s12185-012-1155-1. Epub 2012 Aug 15.
Imatinib was the first BCR-ABL tyrosine kinase inhibitor to become clinically available. In this study, we retrospectively evaluated the long-term efficacy of low-dose imatinib (final maintenance dose <300 mg per day) due to intolerance, in comparison to optimal-dose imatinib (≥300 mg per day) in patients with Philadelphia chromosome-positive chronic myeloid leukemia in the chronic phase. The Kaplan-Meier estimates of the median time to complete cytogenetic response, major molecular response, and complete molecular response were longer for 31 patients receiving low-dose imatinib (360, 1360, and 1420 days, respectively) than 74 patients receiving optimal-dose imatinib (170, 420, and 720 days, respectively). However, the differences in response shrank over time and progression-free survival were comparable between the two groups. These findings suggest that long-term treatment with low-dose imatinib is an acceptable alternative for patients with intolerance to the optimal dose.
伊马替尼是首个临床可用的 BCR-ABL 酪氨酸激酶抑制剂。在这项研究中，我们回顾性评估了因不耐受而接受低剂量伊马替尼（最终维持剂量<300mg/天）与接受最佳剂量伊马替尼（≥300mg/天）的慢性期费城染色体阳性慢性髓性白血病患者的长期疗效。31 例接受低剂量伊马替尼治疗的患者（分别为 360、1360 和 1420 天）达到完全细胞遗传学缓解、主要分子缓解和完全分子缓解的中位时间均长于 74 例接受最佳剂量伊马替尼治疗的患者（分别为 170、420 和 720 天）。然而，随着时间的推移，两组之间的反应差异缩小，无进展生存期相当。这些发现表明，对于不能耐受最佳剂量的患者，长期使用低剂量伊马替尼是一种可接受的替代治疗方法。
