【摘要】 目的重点分析伊马替尼治疗慢性髓系白血病(CML)慢性期的临床疗效与危险度分层之间的相互关系。方法对98例CML慢性期患者,服用伊马替尼前通过Sokal评分、Hasford评分进行危险度分层,比较不同组间的临床疗效是否具有统计学意义。结果 98例患者中,3个月达到血液学缓解(CHR)、部分细胞遗传学缓解(PCyR)的占97.8%及86.4%,6个月达到完全细胞遗传学缓解(CCyR)的比例占82.9%,12个月达到分子学缓解(MMR)的比例占54.5%。入组患者均根据Sokal评分计算危险度分层,服药3个月后低危组、中危组及高危组达到PCyR的比例分别为94.4%、82.6%、66.7%(P=0.104),6个月低危组、中危组及高危组达到CCyR的比例分别为88.2%、76.9%、100.0%(P=0.319),12个月低危组、中危组达到MMR的比例分别为52.4%、65.0%(P=0.412)。根据入组患者服用伊马替尼前情况,有46例患者进行了Hasford分层,低危组21例、中危组23例,高危组2例,3个月达到PCyR的比例分别为90.5%、91.3%、50.0%(P=0.191),随访到6个月,低危组、中危组及高危组达到CCyR的比例分别为83.3%、94.4%、100.0%(P=0.528),随访到12个月,低危组及中危组达到MMR的比例分别为45.5%、58.3%(P=0.842)。结论伊马替尼治疗CML疗效好,低、中危组比高危组更易获得较好的疗效,且坚持足量应用更易获得较好的疗效。更多还原

【Abstract】 Objective To analyse the relationship between the clinical efficacy of imatinib treatment on chronic myeloid leukemia in chronic phaseand risk stratification. Methods 98 imatinib-treated patients were enrolled,and before taking imatinib Sokal and Hasford score were used to assess risk stratification to compare if it has statistical significance between different groups. Results In the 98 cases,89 cases(97. 8%) achieved complete hematologicremission(CHR),76 cases(86. 4%) achieved partial cytogenetic remission( PCyR) after three months,63 cases(82. 9%) achieved complete cytogenetic response(CCyR) after six months and 24 cases(54.5%) achieved major molecular response( MMR) after twelve months. Risk stratification was assessed according to Sokal score. After three months the rate of groups at low,intermediate and high risk categories which achieved PCyR were 94. 4%,82. 6% and 66. 7%,respectively(P = 0. 104),after six months the rate of different groups which achieved CCyR were 88. 2%,76. 9% and 100%,respectively(P = 0. 319),and after twelve months the rate of different groups at low and intermediate risk categories which achieved MMR were 52. 4% and 65. 0%(P = 0. 412). According to the patients’ condition,before taking imatinib,46 patients were stratified by Hasford,among which 21 at low risk categorie,23 at intermediate risk categorie and 2 at high risk categorie. After three months the rate of groups at low,intermediate and high risk categories which achieved PCyR were 90. 5%,91. 3% and 50%,respectively( P =0. 191),after six months the rate of different groups which achieved CCyR were 83. 3%,94. 4% and 100%,respectively(P = 0. 528),and after twelve months the rate of different groups at low and intermediate risk categories which achieved MMR were 45. 5% and 58. 3%(P = 0. 842). Conclusion Imatinib mesylate treatment of chronic myeloid leukemia is good. Patients belonged to low and intermediate risk groups are more likely to get better clinical efficacy than the high-risk group,and insisted on enough applications are easier to achieve nice clinical efficacy.更多还原