甲磺酸伊马替尼治疗慢性粒细胞白血病疗效观察

目的探讨甲磺酸伊马替尼治疗慢性粒细胞白血病（CML）的体会。方法40例CML患者接受甲磺酸伊马替尼治疗，其中慢性期（CP）20例，加速期（AP）8例，急变期（BC）12例。甲磺酸伊马替尼用法：CP患者400mg/d，AP和BC患者600mg/d，均为餐后1次顿服。治疗前全面查体，查血象、骨髓象、Ph染色体和（或）bcr／abl融合基因。治疗期间第1个月每周查血象2次，1个月后每周或2周1次。每2～4周查一次肝、肾功能。待血液学取得完全缓解（CR）后择期复查骨髓、Ph染色体和（或）bcr／abl基因。根据血象和患者对药物耐受情况及时调整药物剂量。结果经中位时间20个月（12～24个月）随访，20倒CMLCP期患者均取得血液学CR，其中7例（35％）Ph染色体转阴，8例AP患者中6例（75％）回到CP，12例BC患者中4例（33．3％）回到CP。药物不良反应有造血功能抑制、眶周和下肢轻度水肿、全身肌肉关节酸痛和恶心、呕吐、低热（37．5～38．5℃）、皮疹、胆红素升高等。结论甲磺酸伊马替尼对CML有较好疗效，药物不良反应可耐受。

Efficacy of imatinib in the treatment of chronic myeloid leukemia

Objective To explore the management experience of imatinib in the treatment of chronic myeloid leukemia （CML）. Methods There were 40 CML. 20 patients in chronic phase（ CP）, 8 patients in accelerated phase（AP） and 12 patients in blast crisis（BC）. The dosage of imatinib was 400 mg/d for CP patients and 600 mg/d for AP and BC patients. The prescribed dose was administrated orally, once daily after a meal with a large glass of water. Before starting the imatinib administration, all the patients had thorough physical examination as well as blood and bone marrow examination. Ph chromosome and or the bcr/abl fusion-gene detection again when they achieved a hematological response（CR）. Dose was adjusted from time to time according to the results of blood examination and the patients tolerance to the drug. Results After a median 20 -month period of follow -up, all the 20 CP patients achieved complete hematological response, including 7 eases （35%） whose Ph chromosome turned negative after treatment. 6（75% ） out of the 8 AP patients and 4（33.3% ） out of the 12 BC patients returned to chronic phase respectively. Adverse events included myelosuppression, periorbital edema or edema of the lower limbs, myalgia and muscle cramps, nausea, vomiting,low fever （ 37.5 - 38.5℃） , tetter and bilirubin inereasinn. Conclusions hnatinib has good efficacy in the treatment of CML. Patients have a good tolerance to imatinib.