[1]陈 静,鞠 镇.一代和二代酪氨酸激酶抑制剂治疗 对CML染色体的影响及疗效[J].现代检验医学杂志,2015,30(01):91-93.[doi:10.3969/j.issn.1671-7414.2015.01.025]
　CHEN Jing,JU Zhen.Chromosome's Influence and Curative Effect on First and Second Generation Tyrosine Kinase Inhibitor Therapy to CML[J].Journal of Modern Laboratory Medicine,2015,30(01):91-93.[doi:10.3969/j.issn.1671-7414.2015.01.025]
点击复制

一代和二代酪氨酸激酶抑制剂治疗 对CML染色体的影响及疗效()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第30卷
期数:
2015年01期
页码:
91-93
栏目:
论著
出版日期:
2015-01-30

文章信息/Info

Title:
Chromosome's Influence and Curative Effect on First and Second Generation Tyrosine Kinase Inhibitor Therapy to CML
文章编号:
1671-7414(2015)01-091-04
作者:
陈 静; 鞠 镇
泰兴市人民医院检验科,江苏泰兴 225400
Author(s):
CHEN Jing; JU Zhen
Department of Clinical Laboratory,Taixing People's Hospital,Jiangsu Taixing 225400,China
关键词:
慢性粒细胞白血病;  染色体;  伊马替尼;  达沙替尼/尼罗替尼
分类号:
R557.3; R446.8
DOI:
10.3969/j.issn.1671-7414.2015.01.025
文献标志码:
A
摘要:
目的 探讨一代和二代酪氨酸激酶抑制剂治疗对慢性粒细胞白血病(CML)患者染色体的影响及疗效。方法 用常规细胞遗传学法对80例Ph+的CML患者进行遗传学分析,同时对比一代和二代酪氨酸激酶抑制剂治疗后CML患者染色体的改变情况及疗效。结果 80例Ph+的CML患者中有11例合并其他的染色体数目及结构异常,其中有10例对伊马替尼耐药或不耐受。伊马替尼(TKI-Ⅰ)治疗的40例患者中有35例达到持续完全细胞遗传学缓解(complete cytogenetic remission,CCyR)(占87.5%),其中有7例3个月时获得CCyR(占17.5%),10例6个月时获得CCyR(占25%),13例12个月时获得CCyR(占32.5%),5例18个月时获得CCyR(占12.5%); 达沙替尼/尼罗替尼(TKI-Ⅱ)治疗的40例患者中有33例达到持续完全细胞遗传学缓解(CCyR)(占82.5%),其中有16例3个月时获得CCyR(占40%),9例6个月时获得CCyR(占22.5%),5例12个月时获得CCyR(占12.5%),3例18个月时获得CCyR(占7.5%)。结论 合并其他染色体异常的Ph+CML患者更容易对伊马替尼产生耐药或不耐受性,尤其是加速期和急变期,一代和二代酪氨酸激酶抑制剂对CML的治疗在长期疗效上相差不大,但近期效果二代优于一代。
Abstract:
Objective Research of chromosome's influence and curative effect on first and second generation tyrosine kinase inhibitor therapy to CML patients.Methods Giving conventional geneticanalysis to 80 Ph+ CML patients,and contrast CML patients'chromosome changingsituation with first and second generation tyrosine kinase inhibitor therapy.Results There were 11 cases with other abnormalities of chromosome number and structure in 80 cases of Ph+ CML patients,and 10 cases wereresistant or intolerant to imatinib.35 patients(87.5%)achieve sustained complete cytogenetic remission(CCyR)who treated with imatinib(TKI-Ⅰ)in the total 40 cases,in these 35 patients,7 cases(17.5%)got CCyR in 3 months; 10 cases(25%)got CCyR in 6 months,13 cases(32.5%)got CCyR in 12 months,and 5 cases(12.5%)got CCyR in 18 months.33 patients(82.5%)achieve sustained completecytogenetic remission(CCyR)who treated with dasatinib/nilotinib(TKI-Ⅱ)in the total 40 cases,in these 33 cases,16 cases(40%)got CCyR in 3 months; 9cases(22.5%)got CCyR in 6 months,5 cases(12.5%)got CCyR in 12 months,and3 cases(7.5%)got CCyR in 18 months.Conclusion Ph+ CML patients combined with other chromosome abnormity were more easily to be resistant or intolerant to imatinib,especially in acceleratd phase and blastic phase.First and second generation tyrosine kinase inhibitor have little difference to treat with CML patients in long time efficacy,but the second generation effect is better than first generation in short time efficacy.

参考文献/References:

[1] Gallioli P,Abraham SA,Holyoake TL.Hurdles toward a cure for CML:the CML stem cell[J].Hematol Oncol Clin North Ame,2011,25(5):951-966.
[2] 邱少伟,王建祥.二代酪氨酸激酶抑制剂的一线治疗进展及选择策略[J].国际输血及血液学杂志,2011,34(3):265-269. Qiu SW,Wang JX.The first-line treatment progress and selective strategy of the second-generation tyrosine kinase inhibitor[J].Int J Blood Transfus Hematol,2011,34(3):265-269.
[3] Milojkovic D,Apperley J.Mechanisms of resistance to imatinib and second-generation tyrosine inhibitors in chronic myeloid leukemia[J].Clin Cancer Res,2009,15(24):7519-7527.
[4] Reece-Smith AM, MacGoey P, Shah MA,et al.A multi-centre analysis ofthe impact of updated risk stratification on follow-up of gastric gastro-intestinal stromal tumours in the post-imatinib era[J].Eur J Surg Oncol,2012,38(6):484-489.
[5] 张之南,郝玉书.血液病学[M].2版.北京:人民出版社,2012:914-915. Zhang ZN,Hao YS.Hematology[M].2th Ed.Beijing:People's Publishing House,2012:914-915.
[6] 王 莉,钱思轩,仇海荣,等.138例慢性髓系白血病衍生9号染色体缺失的研究[J].中国实验血液学杂志,2009,17(2):281-284. Wang L,Qian SX,Qiu HR,et al.Deletions of derivative chromosome 9in 138 patients with chronic myeloid leukemia[J].Journal of Experimental Hematology,2009,17(2):281-284.
[7] 孙 川,李 倩,林 颖,等.慢性粒细胞白血病额外染色体异常在加速期和急变期的意义[J].医学研究杂志,2014,43(1):108-110. Sun C,Li Q,Lin Y,et al.The meaning of additional chromosomal abnormalities in chronic myloid leukemia at accelerated phase and blastic crisis[J].J Med Res,2014,43(1):108-110.
[8] 王 蕾,陈 双,哈力达·亚森.96例慢性粒细胞白血病染色体的初步研究[J].新疆医学,2010,40(1):29-30. Wang L,Chen S,Halida·Yasen.A preliminary study to 96 cases of chronic myeloid leukemia chromosomes[J].Xinjiang Medical,2010,40(1):29-30.
[9] 田 园.达沙替尼治疗伊马替尼耐药的慢性粒细胞白血病的研究进展[J].医学信息,2010,322(8):2292-2293. Tian Y.The treatment progress of dasatinib to imatinib-resistant's chronic myeloid leukemia treatment[J].Medical Information,2010,322(8):2292-2293.
[10] 张䶮莉,魏旭东,房佰俊,等.格列卫治疗慢性粒细胞白血病临床观察[J].中国实用医刊,2010,37(15):43-45. Zhang YL,Wei XD,Fang BJ,et al.Clinical observation of gleever to chronic myeloid leukemia[J].Chinese Journal of Practical Medicine,2010,37(15):43-45.
[11] 昌 盛,李晓光.慢性粒细胞白血病治疗药酪氨酸激酶抑制剂研究进展[J].吉林医药学院学报,2012,33(5):315-317. Chang S,Li XG.Progress of tyrosine kinase inhibitors in the treatment ofChronic Myloid Leukemia[J].Journal of Jilin Medical College,2012,33(5):315-317.
[12] 王爱华,周 励,游建华,等.尼罗替尼治疗对伊马替尼耐药或不耐受的慢性粒细胞白血病临床分析[J].中华血液学杂志,2010,31(1):11-15. Wang AH,Zhou L,You JH,et al.Nilotinib treatment for imatinib resistantor intolerant chronic myelogenous leukemia[J].Chin J Hematol,2010,31(1):11-15.
[13] 贺洁宇.新诊断的慢性髓性白血病患者中尼罗替尼vs伊马替尼的疗效比较[J].肿瘤药学,2012,2(1):80. He JY.Newly diagnosed patients with chronic myelogenous leukemia in the Nile,vs the curative effect of imatinib[J].Tumor Pharmacy,2012,2(1):80.
[14] 郭 杰,冯文莉.酪氨酸激酶抑制剂治疗慢性粒细胞白血病的进展[J].检验医学与临床,2013,10(20):2761-2763. Guo J,Feng WL.Progression of tyrosine kinasinhibitor to chronic myeloidleukemia[J].Lab Med Clin,2013,10(20):2761-2763.
[15] 刘 洋,包尔宁,钟文雯,等.干扰素联合伊马替尼治疗慢性髓系白血病疗效及安全性分析[J].中国实验血液学杂志,2014,22(2):304-306. Liu Y,Bao EN,Zhong WW,et al.Efficacy and safety analysis of interferoncombined with imatinib in treating Chronic Myeloid Leukemia[J].Journal of Experimental Hematology,2014,22(2):304-306.

相似文献/References:

[1]张文静a,郑维威a,宋闿迪b,等.慢性粒细胞白血病患者骨髓单个核细胞中CaMKⅡγ在疾病不同阶段的表达及分子机制[J].现代检验医学杂志,2018,33(03):8.[doi:10.3969/j.issn.1671-7414.2018.03.003]
　ZHANG Wen-jinga,ZHENG Wei-weia,SONG Kai-dib,et al.Expression and Molecular Mechanism of CaMK II Gamma of Bone Marrow Mononuclear Cells in Different Stages of Patients with CML[J].Journal of Modern Laboratory Medicine,2018,33(01):8.[doi:10.3969/j.issn.1671-7414.2018.03.003]
[2]左 娟,刘 洁,朱 瑾,等.无创基因检测(NIPT)对胎儿染色体异常筛查的临床应用[J].现代检验医学杂志,2018,33(05):15.[doi:10.3969/j.issn.1671-7414.2018.05.005]
　ZUO Juan,LIU Jie,ZHU Jin,et al.Application of Noninvasive Prenatal Testing in the Screening of Chromosome Abnormality[J].Journal of Modern Laboratory Medicine,2018,33(01):15.[doi:10.3969/j.issn.1671-7414.2018.05.005]
[3]刘伟平,官凡琪,宋耀辉,等.慢性粒细胞白血病患者BCR-ABL融合基因P210表达对病程判断和预后评估的临床价值[J].现代检验医学杂志,2019,34(05):12.[doi:10.3969/j.issn.1671-7414.2019.05.004]
　LIU Wei-ping,GUAN Fan-qi,SONG Yao-hui,et al.Clinical Value of BCR-ABL Fusion Gene P210 Expression of Patients with Chronic Myeloid Leukemia for Course Judgment and Prognosis Evaluation[J].Journal of Modern Laboratory Medicine,2019,34(01):12.[doi:10.3969/j.issn.1671-7414.2019.05.004]

备注/Memo

备注/Memo:

作者简介:陈 静(1979-),女,学士,主管检验师,主要从事临床微生物与细胞遗传学研究与工作,Tel:13852889885,E-mail:447045011@qq.com。
更新日期/Last Update: 2015-01-30