达沙替尼治疗伊马替尼耐药慢性粒细胞白血病效果
黄婷
（江西省萍乡市湘雅萍矿合作医院血液科，江西萍乡 337000）
摘 要 目的：探讨达沙替尼治疗伊马替尼耐药慢性粒细胞白血病效果。方法：选择2013年6月—2016年1月收治的伊马替尼耐药慢性粒细胞白血病患者40例，随机分为对照组和观察组各20例，对照组采用羟基脲和干扰素治疗，观察组采用达沙替尼治疗，对比分析两组疗效及不良反应。结果：观察组达到完全细胞遗传学反应时间为（4.1±1.4）个月，短于对照组的（5.9±2.2）个月，且持续时间为（16.7±1.9）个月，对照组为（14.4±2.1）个月，组间差异有统计学意义（P＜0.05）。观察组缓解率为80.0%（16/20），对照组为35.0%（7/20），组间差异有统计学意义（P＜0.05）。观察组不良反应发生率为20.0%（4/20），低于对照组的35.0%（7/20，P＜0.05）。结论：达沙替尼治疗伊马替尼耐药慢性粒细胞白血病效果显著，且起效快、不良反应少，值得推广。
关键词慢性粒细胞白血病；伊马替尼；达沙替尼；耐药性
中图分类号：R733.72 文献标志码：A 文章编号：1006-1533（2017）24-0022-02
Effect of dasatinib on treatment of imatinib resistant chronic myeloid leukemia
HUANG Ting
(Jiangxi City of Pingxiang Province Pingxiang Hospital Xiangya Cooperation Blood Specialty, Pingxiang 337000, Jiangxi Province, China) ABSTRACT Objective: To investigate the clinical effect of dasatinib on treatment of imatinib resistant chronic myeloid leukemia. Methods: Forty patients with imatinib resistant chronic myeloid leukemia were enrolled from June 2013 to January 2016, and randomly divided into two groups with 20 cases each. The patients in control group were treated with hydroxyurea and interferon, while the patients in observation group were treated with dasatinib. The therapeutic effect and adverse reaction were compared between two groups. Results: compared with the control group, the observation group achieved a complete cytogenetic response within (4.1±1.4) months, which was shorter than (5.9±2.2) months in control group. The duration of complete cytogenetic response in observation group was (16.7±1.9) months, which was longer than (14.4±2.1) months in control group(P<0.05). The hematologic remission was 80.0%(16/20) in observation group and 35.0%(7/20) in control group with statistical significance(P<0.05). The adverse reaction was 20.0%(4/20) in observation group , which was lower than 35.0%(7/20) in control group(P<0.05). Conclusion: The effect of dasatinib was remarkable in treatment of imatinib resistant chronic myeloid leukemia. It is worthy of promotion for quick effect and less adverse reactions.
KEY WORDS chronic myeloid leukemia; imatinib; dasatinib; drug resistance
慢性粒细胞白血病是造血干细胞的一种恶性骨髓增殖性疾病，通常分为急变期、加速期和慢性期。有研究发现，慢性粒细胞白血病患者出现特异性细胞遗传学改变的概率较高，约为95%，增加了临床治疗难度[1]。临床上在治疗慢性粒细胞白血病时，伊马替尼是常用药物，虽然可以延长患者的生存时间，但容易产生耐药性，降低了治疗效果[2]。本文报道采用达沙替尼治疗伊马替尼耐药慢性粒细胞白血病患者的疗效。
1 资料和方法
1.1 一般资料
选择2013年6月—2016年1月萍乡市湘雅萍矿合作医院血液科收治的40例伊马替尼耐药慢性粒细胞白血病患者，根据数字随机法分为对照组和观察组各20例。观察组中女性12例，男性8例，年龄28~60岁，平均（43.5±12.6）岁；急变期2例，加速期4例，慢性期14例。
·全科医疗和社区护理·
22上海医药 2017年 第38卷 第24期 （12月下）