【摘要】 目的观察伊马替尼、尼洛替尼和达沙替尼对慢性粒细胞白血病(CML)慢性期患者治疗的有效性和安全性。方法 123例接受酪氨酸激酶抑制剂治疗的慢性粒细胞白血病慢性期患者分成3组:A组64例接受伊马替尼治疗;B组31例接受尼洛替尼治疗,C组28例接受达沙替尼治疗,对患者临床资料和随访记录进行总结和分析。治疗18个月后,分析患者的完全细胞遗传缓解百分率(CCyR)、完全血液学缓解率(CHR)和主要分子生物学缓解率(MMR)。结果 A组治疗3,6,12,18个月后CCyR、CHR和MMR都呈现出上升趋势。B和C组治疗12,18个月时,CCyR较A组有显著提高(P<0.05);MMR与A组比较差异有显著统计学意义(P<0.01);3组CHR在各时间节点差异无统计学意义(P>0.05)。3组在随访期间的安全性差异无统计学意义(P>0.05)。结论与伊马替尼相比,尼洛替尼和达沙替尼能更快的在患者体内获得完全细胞遗传学缓解和主要分子生物学缓解,且疗效优于伊马替尼。更多还原

【Abstract】 Objective To compare the clinical efficacy and safety of imatinib,nilotinib and dasatinib on chronic myelogenous leukemia( CML)in chronic phase patients and explore the best first-line treatment for chronic phase CML. Methods A total of 123 patients with chronic phase CML treated by tyrosine kinase inhibitors were divided into three groups: imatinib group A( n = 64); nilotinib group B( n = 31) and dasatinib group C( n = 28). Based on the clinical data and follow-up records,the CCyR、CHR and MMR at 18 months were analyzed in three groups. Results MMR,CHR and CCyR showed a rising trend in imatinib group after 3,6,12,18 months treatment. CCyR in group B and C had been significantly improved( P < 0. 05); CHR in group B and C had significant improvement( P < 0. 01) compared with group A. There was no difference in CHR between three groups at any time. The safety results showed that there was no difference in three groups during the follow-up period. Conclusion Nilotinib and dasatinib treatment can obtain faster complete cytogenetic remission and major molecular remission than imatinib,and the response to treatment is usually dramatic in these groups.更多还原