Li Qin, Jing Li, Wu Peng-Qiang, Han Li-Ying, Xing Hong-Yun, Huang Chun-Lan
Department of Hematology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
Department of Hematology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Feb;32(1):14-19. doi: 10.19746/j.cnki.issn.1009-2137.2024.01.003.
To explore the clinical efficacy and safety of flumatinib mesylate produced in China in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP).
32 newly diagnosed CML-CP patients admitted to the Hematology Department of the Affiliated Hospital of Southwest Medical University from March 1, 2020 to March 31, 2022, who had never received any tyrosine kinase inhibitor (TKI) were included in the study. The patients were treated by flumatinib mesylate 600mg once daily. The hematologic, cytogenetic and molecular responses were assessed at 3-, 6- and 12-month, and adverse effects of the drug were evaluated.
31 patients were treated with flumatinib for≥3 months, of which 24 patients were treated for ≥6 months and 14 patients were treated for≥12 months. At 3rd month of treatment, 30 out of 31 patients achieved complete hematologic response (CHR); 24 patients underwent cytogenetic testing and 22 cases achieved major cytogenetic response(MCyR), of which 21 cases achieved complete cytogenetic response (CCyR); Among 25 patients who underwent molecular testing, 22 patients had BCR-ABL≤10%, including 10 patients with BCR-ABL≤0.1%, and 6 patients with BCR-ABL≤0.01%. At 6th month of treatment, 23 out of 24 patients achieved CHR; 17 patients underwent cytogenetic testing and all achieved CCyR; Among 23 patients who underwent molecular testing, 20 patients had BCR-ABL≤1%, including 16 patients with BCR-ABL≤0.1% and 12 patients with BCR-ABL≤0.01%. At 12nd month of treatment, all 14 patients achieved CHR and CCyR; Among them, 10 patients had BCR-ABL≤0.1%, including 9 patients with BCR-ABL≤0.01%. The grade Ⅲ/Ⅳ leukopenia, thrombocytopenia and anemia rates in the patients were 13.3%, 20.0% and 3.3%, respectively. One patient stopped flumatinib therapy due to severe and persistent hematologic toxicity. The major non-hematologic adverse events were abnormal liver function (20%), diarrhea (10%), bone/joint pain (10%), muscle spasm (10%), rash (6.7%), acute kidney injury (6.7%) and nausea(3.3%), most of which were grade I-II. No patient experienced grade Ⅳ non-hematologic adverse events. No drug toxicity-related death occurred.
Flumatinib mesglate, as the first-line treatment for newly diagnosed CML-CP, can enable the patients to achieve early and deep molecular and cytogenetic responses, and shows good safety.
探讨国产甲磺酸氟马替尼治疗初诊慢性期慢性髓性白血病(CML-CP)患者的临床疗效及安全性。
选取2020年3月1日至2022年3月31日西南医科大学附属医院血液科收治的32例初诊CML-CP患者,这些患者从未接受过任何酪氨酸激酶抑制剂(TKI)治疗。患者接受甲磺酸氟马替尼600mg每日1次治疗。分别于治疗3个月、6个月和12个月时评估血液学、细胞遗传学和分子学反应,并评估药物不良反应。
31例患者接受氟马替尼治疗≥3个月,其中24例患者治疗≥6个月,14例患者治疗≥12个月。治疗3个月时,31例患者中30例达到完全血液学缓解(CHR);24例患者进行了细胞遗传学检测,22例达到主要细胞遗传学缓解(MCyR),其中21例达到完全细胞遗传学缓解(CCyR);25例进行分子检测的患者中,22例患者BCR-ABL≤10%,其中10例患者BCR-ABL≤0.1%,6例患者BCR-ABL≤0.01%。治疗6个月时,24例患者中23例达到CHR;17例患者进行了细胞遗传学检测,均达到CCyR;23例进行分子检测的患者中,20例患者BCR-ABL≤1%,其中16例患者BCR-ABL≤0.1%,12例患者BCR-ABL≤0.01%。治疗12个月时,14例患者均达到CHR和CCyR;其中10例患者BCR-ABL≤0.1%,9例患者BCR-ABL≤0.01%。患者Ⅲ/Ⅳ级白细胞减少、血小板减少和贫血发生率分别为13.3%、20.0%和3.3%。1例患者因严重且持续的血液学毒性停止氟马替尼治疗。主要非血液学不良事件为肝功能异常(20%)、腹泻(10%)、骨/关节痛(10%)、肌肉痉挛(10%)、皮疹(6.7%)、急性肾损伤(6.7%)和恶心(3.3%),大多数为Ⅰ-Ⅱ级。无患者发生Ⅳ级非血液学不良事件。未发生与药物毒性相关的死亡。
甲磺酸氟马替尼作为初诊CML-CP的一线治疗药物,可使患者获得早期且深度的分子学和细胞遗传学反应,且安全性良好。