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格列卫治疗儿童Ph染色体阳性 急性淋巴细胞白血病9例疗效观察

毛彦娜   

  1. 郑州市儿童医院
  • 收稿日期:2016-03-05 修回日期:2016-03-05 出版日期:2016-06-25 发布日期:2016-06-25

Clinical Effects of Gleevec on 9 Cases of Philadelphia Chromosome-positive Acute Lymphoblastic Leukaemia in Children

  1. Zhengzhou Children’s Hospital
  • Received:2016-03-05 Revised:2016-03-05 Online:2016-06-25 Published:2016-06-25

摘要: [摘 要]目的:评价格列卫治疗儿童Ph染色体阳性急性淋巴细胞白血病Ph (acute lymphoblastic leukaemia,Ph ALL)的效果和不良反应。方法:收集我院血液肿瘤科2011年1月至2013年5月确诊的9例Ph ALL患儿,于诱导治疗后开始口服格列卫340 mg/m2?d,30 d为1疗程,每次于饭后0.5 h口服,观察格列卫治疗后Ph ALL患者遗传学缓解率,并记录不良反应。结果:9例患儿口服格列卫后均达到遗传学缓解,缓解率100%(9/9),随访2~4年,中位数时间18个月时的总生存率67%。其中2例于治疗后13个月复发放弃治疗,1例于治疗后6个月复发行异基因造血干细胞移植术。患者在服药后16周(中位时间约3~4周)出现不同程度的血细胞减少。其中7例(78%)出现贫血,5例(56%)出现血小板减少,6例(67%)出现白细胞减少,3例(33%)为全血细胞减少,4例(44%)出现恶心、呕吐胃肠道反应,2例(22%)有肌肉疼痛,予以减量或停药后均可恢复正常。结论:格列卫治疗儿童Ph ALL不仅有效而且安全。

Abstract: [Abstract]Objective: To observe the clinical effect of gleevec on Ph acute lymphoblastic leukaemia(Ph ALL) cases in children.Methods: 9 cases of children Ph ALL were retrospectively analyzed. All of the data were obtained from department of hematology/oncology, in our hospital from January 2011 to May 2014.All the patients were treated with 340 mg/m2·d of oral gleevec in 0.5 h after meals, 30d for a course of treatment meanwhile, observed the genetics remission rate and recorded the occurrence of side effects treated with gleevec. Results: 9 cases(100%) were achieved complete genetic remission.With median follow-up time for 18 months, 9 cases of survival rate of Ph ALL patients was 67% in 2~4 years. Of the patients, 2 cases of recurrence after 13 months gave up treatment.1 case was treated for allogeneic hematopoietic stem cell transplantation after recurrence.Different levels of hypocytosis occured after 16 weeks (medium time was approximately 3~4 weeks).Including animia 7 cases(78%), thrombocytopenia 5 cases(56%), leukocytopenia 6 cases(67%), pancytopenia 3 cases(33%). Nausea and vomiting occurred in 4 cases(44%) and muscle pain occurred in 2 cases(22%) which returned to normal after discontinuation or reduction. Conclusion:Gleevec is both effective and safe for the treatment of Ph ALL.