Kizaki Masahiro, Takahashi Naoto, Iriyama Noriyoshi, Okamoto Shinichiro, Ono Takaaki, Usui Noriko, Inokuchi Koiti, Nakaseko Chiaki, Kurokawa Mineo, Sumi Masahiko, Nakamura Fumihiko, Kawaguchi Tatsuya, Suzuki Ritsuro, Yamamoto Kazuhito, Ohnishi Kazunori, Matsumura Itaru, Naoe Tomoki
Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
Int J Hematol. 2019 Apr;109(4):426-439. doi: 10.1007/s12185-019-02613-1. Epub 2019 Feb 14.
We report the results of a multicenter observational study using the New TARGET system, in which the effectiveness and safety of tyrosine kinase inhibitors (TKIs) were evaluated in newly diagnosed chronic-phase chronic myeloid leukemia (CML) patients. A total of 506 patients were enrolled between April 2010 and March 2013. Median age was 56 (range 18-92) years; 35% of patients were females. As the first-line therapy, 139 (27.9%), 169 (33.9%) and 144 (28.9%) patients were treated with imatinib, nilotinib, and dasatinib, respectively. Five-year progression-free survival (PFS) and overall survival (OS) were 93.8% and 94.5%, respectively. The OS curve was significantly superior for patients treated with second-generation TKIs than imatinib (P = 0.0068), and an early molecular response (EMR) at 3 months (BCR-ABL1 < 10%) was detected in 328 of 377 patients evaluated for molecular response. The PFS curve was significantly superior for patients with EMR than without (P < 0.0001). Although 12 patients experienced vascular adverse events, no new safety issues were observed in patients with adverse events. The results of this observational study demonstrated that treating newly diagnosed CML-CP patients with TKI results in satisfactory and reliable outcomes.
我们报告了一项使用新型TARGET系统的多中心观察性研究结果,该研究评估了酪氨酸激酶抑制剂(TKIs)在新诊断的慢性期慢性髓性白血病(CML)患者中的有效性和安全性。2010年4月至2013年3月期间共纳入了506例患者。中位年龄为56岁(范围18 - 92岁);35%的患者为女性。作为一线治疗,分别有139例(27.9%)、169例(33.9%)和144例(28.9%)患者接受了伊马替尼、尼罗替尼和达沙替尼治疗。五年无进展生存期(PFS)和总生存期(OS)分别为93.8%和94.5%。接受第二代TKIs治疗的患者的OS曲线显著优于接受伊马替尼治疗的患者(P = 0.0068),在377例接受分子反应评估的患者中,有328例在3个月时检测到早期分子反应(EMR,BCR-ABL1<10%)。有EMR的患者的PFS曲线显著优于无EMR的患者(P<0.0001)。虽然有12例患者发生了血管不良事件,但在发生不良事件的患者中未观察到新的安全问题。这项观察性研究的结果表明,用TKI治疗新诊断的CML-CP患者可产生令人满意且可靠的结果。