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伊马替尼在真实世界中对新诊断慢性髓性白血病的治疗效果

[Therapeutic Effect of Imatinib Made in Real World to Newly Diagnosed Chronic Myeloid Leukemia].

作者信息

Ye Yu-Fan, Lyu Xiao-Ming, Li Hai-Liang

机构信息

The First Clinical Medical College of Gannan Medical College; Ganzhou 341000,Jiangxi Province, China.

Department of Information,The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000,Jiangxi Province, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Apr;29(2):456-461. doi: 10.19746/j.cnki.issn.1009-2137.2021.02.024.

Abstract

OBJECTIVE

To evaluate the clinical efficacy and safety of domestic imatinib (made in China) in patients with newly diagnosed chronic myeloid leukemia chronic phase(CML-CP).

METHODS

Fifty-seven newly diagnosed CML-CP patients who did not receive any other anti-CML treatment were treated by domestic imatinib 400 mg once a day. The hematological, cytogenetic and molecular reactions and safety were observed and evaluated after 3, 6 and 12 months of treatment.

RESULTS

Fifty-six patients were treated for ≥3 and 6 months, among which 50 patients were treated for ≥12 months. After 3 months of treatment, 49 patients underwent hematological examination, 47 patients (95.9%) achieved complete hematological response (CHR), 49 patients underwent cytogenetic examination, 39 patients (79.6%) achieved major cytogenetic response (MCyR), and 12 patients (24.5%) achieved complete cytogenetic response (CCyR). 49 patients underwent the level of BCR-ABL test, including 41 patients (83.7%) with BCR-ABL≤10%, and 5 patients (10.2%) with major molecular response (MMR: BCR-ABL ≤ 0.1%). After 6 months of treatment, 49 patients underwent hematological examination, and 49 patients (100%) all achieved CHR. 49 patients underwent cytogenetic examined, of which 41 cases (83.7%) obtained MCyR and 31 cases (65.3%) obtained CCyR. 49 patients underwent the level of BCR-ABL test, among which 33 patients (67.4%) showed BCR-ABL≤1%, and 15 patients(30.6%) reached MMR. After 12 months of treatment, 45 patients underwent hematological examination, and all the patients (100%) got CHR. 45 patients underwent cytogenetic examined, of which 41 cases (91.1%) obtained MCyR and 35 cases (77.8%) obtained CCyR. 45 cases were tested for BCR-ABL level, and 24 cases (55.3%) reached MMR. The incidence of grade Ⅲ leukopenia, thrombocytopenia and anemia were 14.0%, 8.7% and 10.5%, respectively. Non-hematological adverse reactions were edema (64.9%), nausea (50.9%), vomiting (35.1%), rash (24.5%), fever (15.8%), bone and joint muscle pain (38.6%), diarrhea(17.6%) and liver function damage (3.5%). There were no grade IV hematological and non-hematological adverse reactions.

CONCLUSION

In the real world, Domestics imatinib mesylate is effective and safe in the treatment of newly diagnosed CML-CP patients, but long-term follow-up data are still necessary to verify its long-term efficacy.

摘要

目的

评估国产伊马替尼(中国生产)治疗新诊断慢性髓性白血病慢性期(CML-CP)患者的临床疗效及安全性。

方法

57例未接受过其他抗CML治疗的新诊断CML-CP患者,接受国产伊马替尼400mg每日1次治疗。治疗3、6和12个月后观察并评估血液学、细胞遗传学和分子反应及安全性。

结果

56例患者治疗≥3个月和6个月,其中50例患者治疗≥12个月。治疗3个月后,49例患者进行血液学检查,47例(95.9%)达到完全血液学缓解(CHR);49例患者进行细胞遗传学检查,39例(79.6%)达到主要细胞遗传学缓解(MCyR),12例(24.5%)达到完全细胞遗传学缓解(CCyR)。49例患者进行BCR-ABL水平检测,其中41例(83.7%)BCR-ABL≤10%,5例(10.2%)达到主要分子反应(MMR:BCR-ABL≤0.1%)。治疗6个月后,49例患者进行血液学检查,49例(100%)均达到CHR。49例患者进行细胞遗传学检查,其中41例(83.7%)获得MCyR,31例(65.3%)获得CCyR。49例患者进行BCR-ABL水平检测,其中33例(67.4%)BCR-ABL≤1%,15例(30.6%)达到MMR。治疗12个月后,45例患者进行血液学检查,所有患者(100%)均获得CHR。45例患者进行细胞遗传学检查,其中41例(91.1%)获得MCyR,35例(77.8%)获得CCyR。45例进行BCR-ABL水平检测,24例(55.3%)达到MMR。Ⅲ度白细胞减少、血小板减少和贫血的发生率分别为14.0%、8.7%和10.5%。非血液学不良反应有水肿(64.9%)、恶心(50.9%)、呕吐(35.1%)、皮疹(24.5%)、发热(15.8%)、骨和关节肌肉疼痛(38.6%)、腹泻(17.6%)和肝功能损害(3.5%)。无Ⅳ度血液学和非血液学不良反应。

结论

在现实世界中,国产甲磺酸伊马替尼治疗新诊断CML-CP患者有效且安全,但仍需长期随访数据以验证其长期疗效。

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