摘要
目的 了解慢性髓性白血病（CML）患者伊马替尼治疗早期BCR-ABL转录本水平的预后价值,为CML患者早期预后评估和治疗选择提供依据.方法 回顾性分析251例接受伊马替尼—线治疗CML慢性期（CML-CP）患者的临床资料,分别比较治疗后3个月及6个月不同BCR-ABL转录本水平患者的无进展生存（PFS）率及总体生存（OS）率,并采用卡方检验及Logistic回归分析方法分析疾病进展的危险因素.结果 伊马替尼治疗3个月BCR-ABL转录本＞10％组（92例）、＞1％～10％组（94例）、≤1％组（65例）的PFS率分别为53.3％、71.3％、86.2％ （P＜0.05）,OS率分别为92.4％、96.8％和93.8％ （P＞0.05）.伊马替尼治疗后6个月时BCR-ABL转录本＞10％组（22例）、＞1％～10％（50例）组、≤1％（110例）组PFS率分别为27.3％、66.0％和82.7％（P＜0.05）,OS率分别为86.4％、94.0％、100％（P＜0.05）.Logistic回归分析结果显示3个月及6个月BCR-ABL转录本水平为影响疾病进展的独立危险因素.结论 伊马替尼治疗3个月及6个月BCR-ABL转录本水平对CML患者预后评估具有重要价值.
Objective To understand the prognostic value of early monitoring BCR-ABL transcripts in patients with chronic myeloid leukemia（CML） after treatment with imatinib,and to provide the information for early assessment of prognosis and treatment options.Methods The clinical data of 251 patients with CML in chronic phase （CML-CP） who received imatinib as first-line therapy were retrospectively analyzed,the progression-free survival （PFS） and overall survival （OS） between different BCR-ABL transcriptional level at 3 and 6 month after imatinib treatment were compared.Meanwhile,Chi-square test and logistic regression were used to analyze the risk factors for disease progression.Results At 3 months after imatinib treatment BCR-ABL transcriptional levels〉10%,〉1%-≤10% and ≤1% were found in 92,94and 64patients,their PFS were 53.3%,71.3% and 86.2%,respectively.The results showed that the PFS of patients with low BCR-ABL transcriptional levels was significantly superior to that with high BCR-ABL transcriptional levels for CML at 3 months treatment （P〈0.05）.The OS of three group did not reach statistical significance （92.4% vs 96.8% vs 93.8%,P〉0.05）.When 182 patients receivedimatinib treatment at 6 months,22 patients with BCR-ABL transcriptional levels〉10%,50〉1%-≤10% and 110 ≤1%,their PFS were 27.3% vs 66.0% vs 82.7%（P〈0.05）,the OS of three groups were 86.4% vs 94.0% vs 100%.There were significant differences among the three groups （P〈0.05）.Logistic regression confirmed that the level of BCR-ABL transcriptional level at 3 and 6 months after imatinib treatment was independent factor to influence the progress of disease.Conclusion It is important for the prognosis evaluation of CML patients to monitor BCR-ABL transcriptional level at 3 and 6 months after imatinib treatment.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2015年第7期553-558,共6页
Chinese Journal of Hematology
基金
国家高科技研究发展计划（863计划）（2012AA02A505）
“江苏省临床医学中心”资质项目（ZX201102）
江苏高校优势学科建设工程资助项目（PAPD）
国家临床重点专科建设项目
