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伊马替尼治疗儿童和青少年慢性髓性白血病早期分子反应的影响:一项来自中国的单中心研究。

The impact of early molecular response in children and adolescents with chronic myeloid leukemia treated with imatinib: a single-center study from China.

作者信息

Shao Haigang, Zeng Zhao, Cen Jiannong, Zhang Jun, Bai Shuxiao, Wu Chunxiao, Gong Yanlei, Wang Yong, Qiu Huiying, Chen Suning, Pan Jinlan

机构信息

a Key Laboratory of Thrombosis and Hemostasis , Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University , Suzhou , P.R. China.

出版信息

Leuk Lymphoma. 2018 Sep;59(9):2152-2158. doi: 10.1080/10428194.2017.1422860. Epub 2018 Jan 15.

Abstract

Chronic myeloid leukemia (CML) is rare among children and adolescents. The early molecular response (EMR) is an important prognostic significance for adult CML patients. This study explored the impact of EMR on the prognosis in 40 children and adolescents with CML-CP treated with imatinib (IM). Our results showed that a high proportion of patients failed to achieve the BCR-ABL1/ABL1 International Scale (IS) ≤ 10% at 3 months. Children with a BCR-ABL1/ABL1 ≤ 10% at 3 months and <1% at 6 months increased the rate of achieving complete cytogenetic response (CCyR) and/or major molecular response (MMR) at 12 months compared to those with BCR-ABL1/ABL1 > 10%. With a median follow-up of 42 months, patients with BCR-ABL1/ABL1 ≤ 10% showed a better 4-year event-free survival (EFS). In summary, achieving BCR-ABL1/ABL1 IS ≤10% at 3 months and <1% at 6 months would increase the possibility of achieving MMR, CCyR at 12 months and had a better 4-year EFS. EMR is a reliable prognosticator for young CML patients treated with IM.

摘要

慢性髓性白血病(CML)在儿童和青少年中较为罕见。早期分子反应(EMR)对成年CML患者具有重要的预后意义。本研究探讨了EMR对40例接受伊马替尼(IM)治疗的慢性期儿童和青少年CML患者预后的影响。我们的结果显示,高比例的患者在3个月时未能达到BCR-ABL1/ABL1国际量表(IS)≤10%。与BCR-ABL1/ABL1>10%的儿童相比,3个月时BCR-ABL1/ABL1≤10%且6个月时<1%的儿童在12个月时达到完全细胞遗传学反应(CCyR)和/或主要分子反应(MMR)的比例增加。中位随访42个月,BCR-ABL1/ABL1≤10%的患者4年无事件生存率(EFS)更佳。总之,3个月时达到BCR-ABL1/ABL1 IS≤10%且6个月时<1%会增加12个月时达到MMR、CCyR的可能性,并具有更好的4年EFS。EMR是接受IM治疗的年轻CML患者的可靠预后指标。

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