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氟马替尼治疗初诊慢性髓性白血病慢性期的疗效和安全性:一项真实世界的单中心回顾性研究,重点关注提前停药。

Efficacy and safety of flumatinib in the treatment of newly diagnosed chronic myeloid leukemia in the chronic phase: A real-world single-center retrospective study, with a focus on premature drug discontinuation.

机构信息

Qilu Hospital of Shandong University, Department of Hematology, Jinan, Shandong, China.

Qilu Hospital of Shandong University, Department of Hematology, Jinan, Shandong, China.

出版信息

Leuk Res. 2024 Jul;142:107507. doi: 10.1016/j.leukres.2024.107507. Epub 2024 Apr 26.

Abstract

PURPOSE

To assess the real-world efficacy and safety of flumatinib as first-line and post-line treatments for chronic myeloid leukemia in the chronic phase (CML-CP).

RESULTS

Among 141 patients receiving flumatinib as first-line and post-line treatment, the 12-month major molecular response (MMR) rates were 69.4% and 67.6%, respectively. The median time to response was 6 and 10.5 months, respectively. In post-line treatment, the early molecular response (EMR) of flumatinib as second-line is significantly superior to that of third-line treatment (3-month EMR rate: 79.2% vs. 39.3%, P<0.001; 3-month MMR rate: 45.8% vs. 21.4%, P=0.033). Contrastively, patients who switched to flumatinib due to intolerance had significantly higher MMR rates at 3, 6, and 12 months compared to patients who switched due to inadequate response (60.6% vs. 24.2%, P=0.003; 66.7% vs. 36.0%, P=0.027; 84.2% vs. 50.0%, P=0.038). Premature drug discontinuation was observed in 28.4% of the patients. Grades 3-4 hematologic adverse events (AEs) were identified as independent risk factors for premature drug discontinuation. Patients who discontinued treatment and those who previously received only imatinib therapy had a poorer molecular response and failure-free survival.

CONCLUSIONS

Flumatinib demonstrates favorable efficacy and safety. Treatment discontinuation can result in a poorer molecular response and long-term prognosis.

摘要

目的

评估氟马替尼作为一线和后线治疗慢性髓性白血病慢性期(CML-CP)的真实世界疗效和安全性。

结果

在 141 例接受氟马替尼一线和后线治疗的患者中,12 个月主要分子反应(MMR)率分别为 69.4%和 67.6%。中位反应时间分别为 6 个月和 10.5 个月。在后线治疗中,氟马替尼作为二线治疗的早期分子反应(EMR)明显优于三线治疗(3 个月 EMR 率:79.2%对 39.3%,P<0.001;3 个月 MMR 率:45.8%对 21.4%,P=0.033)。相比之下,因不耐受而转换为氟马替尼的患者在 3、6 和 12 个月的 MMR 率明显高于因疗效不足而转换为氟马替尼的患者(60.6%对 24.2%,P=0.003;66.7%对 36.0%,P=0.027;84.2%对 50.0%,P=0.038)。28.4%的患者提前停药。3-4 级血液学不良事件(AE)被确定为提前停药的独立危险因素。停药患者和仅接受伊马替尼治疗的患者的分子反应和无失败生存较差。

结论

氟马替尼具有良好的疗效和安全性。停药会导致分子反应和长期预后较差。

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