【摘要】 目的:回顾性分析和比较伊马替尼治疗新诊断和重组人干扰素α2b(以下简称干扰素)治疗失败的慢性髓性白血病患者的疗效。方法:收集86例应用伊马替尼(每天400mg)治疗的慢性髓性白血病患者的临床资料,其中新诊断患者61例,干扰素治疗失败患者25例;采用R显带技术和实时定量PCR检测细胞遗传学和BCR-ABL融合基因进行疗效分析比较。结果:新诊断组和干扰素治疗失败组治疗6个月时就获得部分细胞遗传学缓解的患者分别为50/61(81.9%)和9/25(36.0%);两组获得完全细胞遗传学缓解的患者分别为53/61例(86.9%)和17/25例(68.0%),差异有统计学意义(P<0.001);两组患者达到完全细胞遗传学缓解的中位时间分别为10个月(3~34个月)和5个月(1~17个月),差异有统计学意义(P=0.001)。新诊断组和干扰素治疗失败组获得完全分子生物学反应分别为43/61(70.4%)和10/25(40.0%),差异有统计学意义(P=0.033)。两组患者中有28例是细胞遗传学耐药,新诊断组为14例(22.9%),其中原发性细胞遗传学耐药4例;干扰素治疗失败组为14例(56.0%),均为原发性细胞遗传学耐药。结论:干扰素治疗失败的慢性髓性白血病患者应用伊马替尼治疗,其原发耐药发生率高,治疗6个月和12个月获得最佳反应的患者比例低;提示这些患者应适时更换第二代酪氨酸激酶抑制剂治疗。更多还原

【Abstract】 Objective:To evaluate the efficacy of imatinib mesylate(IM) for patients with newly diagnosed chronic myeloid leukemia(CML) and patients after failure of Recombinant Human interferon-α2b(IFN-α2b) therapy.Methods:A total of 86 patients with CML in chronic-phase,including 61 newly diagnosed cases and 25 cases of IFN-α2b failure,who received IM at 400 mg daily were retrospectively analyzed.Conventional cytogenetic analysis of R-banding was used to detect chromosome abnormalities and real-time PCR was used to detect BCR-ABL fusion gene.Results:81.9%of newly diagnosed patients and 36.0%of IFN-α2b failure patients achieved partial cytogenetic response(PCyR) by 6 months.In addition,86.9%of newly diagnosed patients and 68.0%of IFN-α2b failure patients achieved complete cytogenetic response(CCyR) in 24 months.There was significant difference between two groups(P <0.001).The median time achieved CCyR in newly diagnosed group and IFN-α2b failure group were 6 months and 15 months,respectively.Compared with newly diagnosed group,IFN-α2b failure group showed lower rate of complete molecular remission(CMR)(70.4%vs 40.0%,P=0.033).There are 14 patients(22.9%)in newly diagnosed patients with cytogenetic resistance,among whom 4 with primary cytogenetic resistance;while there were 14 patients(56.0%) in IFN-α2b failure group with cytogenetic resistance,all of whom with primary resistance.Conclusion;Compared with newly diagnosed patients,CML patients after failure of IFN-α2b therapy have a high rate of primary cytogenetic resistance and low response rate to IM.更多还原