慢性粒细胞白血病合并骨髓纤维化患者疗效的观察

张震东; 曾庆曙; 倪静

doi:10.13201/j.issn.1004-2806.2019.01.006

慢性粒细胞白血病合并骨髓纤维化患者疗效的观察

- 安徽医科大学第一附属医院血液内科(合肥, 230022)

详细信息

通讯作者: 曾庆曙,E-mail:Zengqingshu2014@163.com

中图分类号: R733.72

收稿日期: 2018-11-28

Clinical observation on the curative effect of chronic myeloid leukemia with marrow fibrosis

- Department of Hematology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China

More Information

Corresponding author: CENG Qingshu, E-mail: Zengqingshu2014@163.com

Received Date: 28 November 2018

摘要

摘要: 目的:观察慢性粒细胞白血病(CML)合并骨髓纤维化患者使用伊马替尼等TKI药物作为一线治疗的疗效和相关不良反应。方法:收集136例初治的CML慢性期患者,按照欧洲骨髓纤维化分级标准,将骨髓纤维化程度分为3组:骨髓纤维化(-/+)组65例,骨髓纤维化(++)组40例,骨髓纤维化(+++)组31例。观察3组患者使用伊马替尼治疗后12个月的临床疗效及相关不良反应。结果:在主要分子生物学反应方面,骨髓纤维化(-/+)组获得率明显高于骨髓纤维化(++)及骨髓纤维化(+++)组,分别为84.62%、65.00%、54.84%。根据NCI/NIH毒性标准分级,在血液学毒性方面,3组患者多为Ⅰ~Ⅱ级不良反应,大多具有自限性,Ⅲ~Ⅳ级不良反应少见。骨髓纤维化(-/+)组血液学毒性发生率明显低于骨髓纤维化(++)及骨髓纤维化(+++)组,分别为32.31%、47.50%、74.19%。结论:无明显骨髓纤维化的CML患者能更多的达到主要分子生物学缓解,且血液学毒性较少。
- 慢性粒细胞白血病 /
- 骨髓纤维化 /
- 血液学毒性
Abstract: Objective:To observe the curative effect and related adverse events of imatinib and other TKI drugs as first-line treatment in patients with chronic myelogenous leukemia (CML) combined with myelofibrosis.Method:A total of 136 cases of CML patients initially treated were collected and the degree of fibrosis was divided into three groups according to the European classification standard of bone marrow fibrosis:65 cases of bone marrow fibrosis (-/+),40 cases of bone marrow fibrosis (++) and 31 cases of bone marrow fibrosis (+++).The clinical efficacy and related adverse events were observed 12 months after the use of imatinib among the three groups of patients.Result:In terms of the major molecular biological response,the yield rate of the bone marrow fibrosis (-/+) group was significantly higher than those of the bone marrow fibrosis (++) and (+++) groups,which were 84.62%,65.00% and 54.84%.According to the NCI/NIH toxicity standard classification,in terms of the hematological toxicity,most patients in the three groups were gradeⅠ-Ⅱ adverse events and were self-limited,while grade Ⅲ-Ⅳ adverse events were rare.The incidence of hematological toxicity in the bone marrow fibrosis (-/+) group was significantly lower than those in the bone marrow fibrosis (++) and (+++) groups,which were 32.31%,47.50 and 74.19%.Conclusion:CML patients without significant bone marrow fibrosis can achieve major molecular biological remission and have less hematological toxicity.
- chronic myeloid leukemia /
- marrow fibrosis /
- hematological toxicity

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