Aïssata Tolo Diebkilé, Sawadogo Duni, Nanho Clotaire, Kouakou Boidy, Meité N'dogomo, Emeuraude N'dhatz, Roméo Ayémou, Yassongui Mamadou Sekongo, Kouéhion Paul, Mozart Konan, Koffi Gustave, Sanogo Ibrahima
Department of Clinical Hematology, Yopougon Teaching Hospital, P.O. Box 632, Abidjan 21, Cote d'Ivoire.
Adv Hematol. 2013;2013:901589. doi: 10.1155/2013/901589. Epub 2013 May 29.
Imatinib mesylate provides good results in the treatment of CML in general. But what about the results of this treatment in CML associated with additional cytogenetic abnormalities at diagnosis among black Africans? For this, we retrospectively studied 27 cases of CML associated with additional cytogenetic abnormalities, diagnosed in the department of clinical hematology of the University Hospital of Yopougon in Côte d'Ivoire, from May 2005 to October 2011. The age of patients ranged from 13 to 68 years, with a mean age of 38 years and a sex ratio of 2. Patients were severely symptomatic with a high Sokal score of 67%. CML in chronic phase accounted for 67%. The prevalence of additional cytogenetic abnormalities was 29.7%. There were variants of the Philadelphia chromosome (18.5%), trisomy 8 (14.8%), complex cytogenetic abnormalities (18.5%), second Philadelphia chromosome (14.8%), and minor cytogenetic abnormalities (44.4%). Complete hematologic remission was achieved in 59%, with 52% of major cytogenetic remission. The outcome was fatal in 37% of patients. Death was related in 40% to hematologic toxicity and in 30% to acutisation. The median survival was 40 months.
总体而言，甲磺酸伊马替尼在慢性粒细胞白血病（CML）的治疗中效果良好。但在非洲黑人中，这种治疗方法对于诊断时伴有其他细胞遗传学异常的CML患者的治疗效果如何呢？为此，我们回顾性研究了2005年5月至2011年10月在科特迪瓦约普贡大学医院临床血液科诊断的27例伴有其他细胞遗传学异常的CML病例。患者年龄在13至68岁之间，平均年龄为38岁，男女比例为2。患者症状严重，索卡尔评分高达67%。慢性期CML占67%。其他细胞遗传学异常的发生率为29.7%。包括费城染色体变异（18.5%）、8号染色体三体（14.8%）、复杂细胞遗传学异常（18.5%）、第二条费城染色体（14.8%）以及微小细胞遗传学异常（44.4%）。59%的患者实现了完全血液学缓解，主要细胞遗传学缓解率为52%。37%的患者预后不良。40%的死亡与血液学毒性有关，30%与病情急性化有关。中位生存期为40个月。
