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酪氨酸激酶抑制剂时代治疗相关慢性髓性白血病的发病率和结局:慢性髓性白血病协作研究组的监测

Incidences and outcomes of therapy-related chronic myeloid leukemia in the era of tyrosine kinase inhibitors: Surveillance of the CML Cooperative Study Group.

作者信息

Iriyama Noriyoshi, Tokuhira Michihide, Takaku Tomoiku, Sato Eriko, Ishikawa Maho, Nakazato Tomonori, Sugimoto Kei-Ji, Fujita Hiroyuki, Fujioka Isao, Hatta Yoshihiro, Kizaki Masahiro, Komatsu Norio, Asou Norio, Kawaguchi Tatsuya

机构信息

Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.

Departments of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.

出版信息

Leuk Res. 2017 Mar;54:55-58. doi: 10.1016/j.leukres.2017.01.003. Epub 2017 Jan 5.

DOI:10.1016/j.leukres.2017.01.003
PMID:28109974
Abstract

This study was performed to investigate the features and outcome of patients with therapy-related chronic myeloid leukemia (TR-CML) who were treated with tyrosine kinase inhibitors (TKIs). The analysis included 308 patients with CML in the chronic phase who were extracted from the CML Cooperative Study Group database. Of these patients, 11 (3.6%) were identified as having TR-CML. No differences in age, sex, white blood cell count, hemoglobin level, platelet count, or European Treatment and Outcome Study risk were observed between patients with TR-CML vs. de novo CML. However, the responses of TR-CML patients to TKIs (6, 3, and 2 received imatinib, nilotinib, and dasatinib, respectively) were excellent; all achieved major or deep molecular response. Furthermore, the outcomes of TR-CML patients were relatively favorable; the 3-year event-free survival rates in the TR-CML and de novo CML patients were 100% and 94%, respectively; the difference was not statistically significant. In conclusion, our study showed that TR-CML patients could achieve a good clinical course with TKI therapy. Detailed investigations of TR-CML may provide new insights into CML biology.

摘要

本研究旨在调查接受酪氨酸激酶抑制剂(TKIs)治疗的治疗相关慢性髓性白血病(TR-CML)患者的特征及预后。分析纳入了从慢性髓性白血病协作研究组数据库中提取的308例慢性期慢性髓性白血病患者。其中,11例(3.6%)被确定为患有TR-CML。TR-CML患者与初发慢性髓性白血病患者在年龄、性别、白细胞计数、血红蛋白水平、血小板计数或欧洲治疗与预后研究风险方面未观察到差异。然而,TR-CML患者对TKIs的反应(分别有6例、3例和2例接受伊马替尼、尼洛替尼和达沙替尼治疗)良好;均达到主要或深度分子反应。此外,TR-CML患者的预后相对良好;TR-CML患者和初发慢性髓性白血病患者的3年无事件生存率分别为100%和94%;差异无统计学意义。总之,我们的研究表明,TR-CML患者接受TKI治疗可获得良好的临床病程。对TR-CML的详细研究可能为慢性髓性白血病生物学提供新的见解。

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