慢性髓系白血病的临床治疗研究血液内科学专业毕业论文.docx

PAGE PAGE IV 慢性髓系白血病的临床治疗研究 中文摘要 （1）伊马替尼（CML-CP）组 EFS 为 88.5%，OS 为 93.2%，预期 5 年 EFS 84%、 5 年 OS 92%；而异基因造血干细胞移植组（CML-CP）组 EFS 为 70%，OS 为 80%， 预期 5 年 EFS 75%、5 年 OS 79%。两组比较，伊马替尼组 EFS 及 OS 均明显高于异 基因造血干细胞移植组（P 值均0.05）。（2）伊马替尼（AP+BC）组 EFS 为 42.9 %， OS 为 42.9 %；而异基因造血干细胞移植组（AP+BC）组 EFS 为 47.6 %，OS 为 57.1%。 两组比较，EFS 及 OS 无明显统计学差异。 结 论 对于 CML-CP 患者，伊马替尼组 EFS 及 OS 均明显高于异基因造血干细胞移植 组；对于 AP 或 BC 期患者，两组无明显统计学差异，但本组 AP+BC 期患者病例数 少，有待更多病例进一步研究。 关键词：白血病，髓系，慢性，伊马替尼，异基因造血干细胞移植 作 者: 周 敏 指导教师: 仇惠英 本课题受江苏高校优势学科建设工程资助项目及江苏省临床医学中心资助项目 （ZX201102）资助 Abstract Study of clinical treatment of Chronic Myeloid Leukemia Study of clinical treatment of Chronic Myeloid Leukemia Abstract Part one To evaluate the effect of Imatinib on treatment of 214 patients with chronic myeloid leukemia and Multivariate Analysis Imatinib Resistance factors For CML patients Objective To discuss curative effect of imatinib and imatinib resistance-related factors for chronic myeloid leukemia patients. Methods 214 patients of chronic myeloid leukemia received imatinib treatment in our hospital from April 2005 to December 2010. The therapy history and curative effect were regular followed up at outpatient ward in our hospital and influencing factors of drug resistance were analyzed. Cox regression analysis was used to perform the single factor and multi-factors analysis. Results To the deadline, thirty-one patients(14.49%) appeared drug resistance.One of them was in accelerate phase, and two of them were in blastic phase. 69.2% patients achieved complete cytogenetic response(CCyR). 31.3% patients achieved major molecular response(MMR). We performed cox analysis with the 207 patients who were in chronic phase.Single factor cox regression analysis showed:the course before treatment 、the hemoglobin count、the white blood cell count、whether achieved complete cytogenetic response or not and whether achieved major molecular response or not are the influencing factors for imatinib resistance. The result of multi-f