Bělohlávková Petra, Voglová Jaroslava, Radocha Jakub, Žák Pavel
Vnitr Lek. 2015 Sep;61(9):785-6, 788-91.
Treatment of chronic myeloid leukemia (CML) with tyrosine kinase inhibitors (TKI) has significantly changed the survival of patients of all age categories. In our work, we have tried retrospectively to analyze a therapeutic response and toxicity of imatinib according to age of patients ( 60 years vs > 60 years). Patients have started treatment with imatinib in 2001-2013 in our department. The duration of treatment was at least 18 months.
The whole group contains 103 patients (52 women, 51 men) with a median age at diagnosis of CML 55 years (range 19-88 years). The first group includes 68 the younger patients (31 women, 37 men) with a median age at diagnosis 43 years (range 19-59 years) and the second group 35 the elderly patients (21 women, 14 men) with a median age at diagnosis 70 years (range 61-86 years). Median imatinib dose in both groups was the same - 400 mg per day (range 200-600 mg).
In the elderly patients we observed higher rates of hematological toxicities (p = 0.0059). After 12 months treatment, a complete cytogenetic response (CCyR) was achieved in 90 % of younger patients and in 74 % of the elderly patients, respectively. Major molecular response (MMR) at 18 months treatment was achieved in 79 % of the younger group and in 63 % of the elderly group.
The results represent in both groups very good therapeutic response independent of age of patients at the time of CML diagnosis.
使用酪氨酸激酶抑制剂（TKI）治疗慢性粒细胞白血病（CML）显著改变了各年龄段患者的生存率。在我们的研究中，我们试图回顾性分析伊马替尼根据患者年龄（60岁及以下与60岁以上）的治疗反应和毒性。患者于2001年至2013年在我们科室开始使用伊马替尼治疗。治疗持续时间至少为18个月。
整个队列包含103例患者（52例女性，51例男性），CML诊断时的中位年龄为55岁（范围19 - 88岁）。第一组包括68例较年轻患者（31例女性，37例男性），诊断时的中位年龄为43岁（范围19 - 59岁），第二组包括35例老年患者（21例女性，14例男性），诊断时的中位年龄为70岁（范围61 - 86岁）。两组伊马替尼的中位剂量相同，均为每日400 mg（范围200 - 600 mg）。
在老年患者中，我们观察到血液学毒性发生率更高（p = 0.0059）。治疗12个月后，较年轻患者和老年患者的完全细胞遗传学缓解（CCyR）率分别为90%和74%。治疗18个月时，较年轻组和老年组的主要分子缓解（MMR）率分别为79%和63%。
结果表明两组在CML诊断时无论患者年龄大小均有非常好的治疗反应。
