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1、中华血液学杂志2003年6月第24卷第6期ChinJHematol,June2003,Vol24,No.6·281··论著·格列卫治疗54例Ph阳性慢性髓细胞白血病江浩陈珊珊江滨江倩陆道培【摘要】目的评价甲磺酸伊马替尼(商品名格列卫)治疗Ph阳性慢性髓细胞白血病慢性期(CML2CP)的有效性及安全性。方法54例对α干扰素(IFN2α)耐药或不能耐受及异基因干细胞移植(allo2SCT)后复发的CML2CP患者口服格列卫400mgPd,持续6～11个月。结果全部患者于服药后7～28天达到血液学完全缓解。1例服药后7个月复发,很
2、快进展为加速期。观察截止时,血液学完全缓解为52例(98%)。发生主要遗传学效应为37例(70%),其中遗传学完全缓解为27例(51%)。37例中29例(78%)患者达到主要遗传学缓解的时间为3个月。约10%患者出现Ⅲ级白细胞和(或)血小板减少,多可控制或耐受。Ⅲ～Ⅳ级非血液学不良反应很少发生。仅1例患者因药物不良反应退出。结论①格列卫对经IFN2α治疗失败的CML2CP有较高的血液学及遗传学缓解率,且起效迅速;②格列卫服用方便,不良反应轻微、多可耐受或自行消失。【关键词】伊马替尼;白血病,髓样,慢性Treatmentof5
3、4chronicmyelogenousleukemiawithGleevecJIANGHao,CHENShan2shan,JIANGBin,JIANGQian,LUDao2pei.InstituteofHematology,People’sHospital,BeijingUniversity,Beijing100044,Chi2na【Abstract】ObjectiveToevaluatetheefficacyandsafetyofGleevec(Imatinib)inthetreatmentofpatientswithPh
4、positivechronicmyeloidleukemiainchronicphase(CML2CP).MethodsAtotalof54CML2CPpatientsinwhomprevioustherapywithinterferon2αhadbeenfailedoruntolerated,orrelapsedafterallogeneicstemcelltransplantation(allo2SCT)weretreatedwith400mgPdoforalGleevecfor6to11months.ResultFif
5、ty2threepa2tientsbeingabletoevaluateachievedcompletehematologicalresponsewithin7to28days.Fifty2two(98%)ofthemremainedinthissituationatlastfollow2up.Onepatientrelapsedafter7months’treatment,andprogressedtoacceleratedphase.Gleevecinducedmajorcytogeneticresponsein37pa
6、tients(70%)andcompletecytogeneticre2sponsein27(51%).Twenty2nineof37patients(78%)achievedmajorcytogeneticresponsewithin3months.Grade3neutropeniaorthrombocytopeniaoccurredinabout10%ofpatients,whichweremanageableortolerated.Grade3or4nonhematologicadverseeffectswereinf
7、requent.Only1patient(2%)discontinuedtreatmentbecauseofdrug2relatedadverseevents.ConclusionsGleevecinducedhighrateofcytogeneticandhematologicresponsesinpatientswithCML2CPwhofailedinpreviousinterferontherapy.Theadverseeffectsweremildandmanageable,ornoneedfortreatment
8、.【Keywords】Imatinib;Leukemia,myelogenous,chronic甲磺酸伊马替尼[STI571,商品名格列卫察结果。(Gleevec)]是一种22苯氨嘧啶衍生物,它通过取代病例和方法BCR2ABL融合蛋白中的ATP而阻断ABL酪氨酸激酶的持续磷酸化,从而达到抑
