格列卫治疗54例Ph阳性慢性髓细胞白血病

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(CML-CP)的有效性及安全性。方法54例对α干扰素(IFN-α)耐药或不能耐受及异基因干细胞移植(allo—SCT)后复发的CMI-CP患口服格列卫400mg／d，持续6-11个月。结果全部患于服药后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％)患达到主要遗传学缓解的时间为3个月。约10％患出现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例患因药物不良反应退出。结论①格列卫对经IFN—α治疗失败的CMI-CP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。

Treatment of 54 chronic myelogenous leukemia with Gleevec

OBJECTIVE: To evaluate the efficacy and safety of Gleevec (Imatinib) in the treatment of patients with Ph positive chronic myeloid leukemia in chronic phase (CML-CP). METHODS: A total of 54 CML-CP patients in whom previous therapy with interferon-alpha had been failed or untolerated, or relapsed after allogeneic stem cell transplantation (allo-SCT) were treated with 400 mg/d of oral Gleevec for 6 to 11 months. RESULT: Fifty-three patients being able to evaluate achieved complete hematological response within 7 to 28 days. Fifty-two (98%) of them remained in this situation at last follow-up. One patient relapsed after 7 months' treatment, and progressed to accelerated phase. Gleevec induced major cytogenetic response in 37 patients (70%) and complete cytogenetic response in 27 (51%). Twenty-nine of 37 patients (78%) achieved major cytogenetic response within 3 months. Grade 3 neutropenia or thrombocytopenia occurred in about 10% of patients, which were manageable or tolerated. Grade 3 or 4 nonhematologic adverse effects were infrequent. Only 1 patient (2%) discontinued treatment because of drug-related adverse events. CONCLUSIONS: Gleevec induced high rate of cytogenetic and hematologic responses in patients with CML-CP who failed in previous interferon therapy. The adverse effects were mild and manageable, or no need for treatment.