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目的 评价STI571联合化疗或造血干细胞移植（HSCT）治疗慢性粒细胞性白血病（CML）的疗效。方法总结2001年5月至2002年7月间我院10例CML患者采用STI571单药或联合化疗或造血干细胞治疗情况。结果3例慢性期（CP）和1例急变期（AP）患者单用STI571治疗3个月后均获血液学和细胞遗传学完全缓解（CR）;1例加速期（AP）和5例急变期（BP）STI571与1～2个疗程化疗获血液学CR2例,PR3例,总有效率为83％（5/6）,获细胞遗传学CR1例,细胞遗传学好转3例。4例STI571治疗有效患者,3例进行异基因HSCT,1例进行自体HSCT治疗,2例患者至今存活,另2例患者分别死于重症肝炎和白血病复发。结论STI571单药对CML各期患者均有效,对CML-CP患者疗效优于CML-AP及CML-BP患者,化疗不能提高STI571对CML-AP和BP患者的疗效。STI571在HSCT移植中应用不影响造血重建。
Objective To evaluate the efficacy of STI571 combined with chemotherapy or hematopoietic stem cell transplantation (HSCT) in the treatment of chronic myelogenous leukemia (CML). Methods From May 2001 to July 2002, 10 cases of CML in our hospital were treated with STI571 monotherapy or combined with chemotherapy or hematopoietic stem cell therapy. Results Three patients with chronic phase (CP) and one patients with acute phase (AP) were treated with STI571 for 3 months and achieved complete hematologic and cytogenetic complete remission (CR). One case of accelerated phase (AP) and five cases of acute exacerbation (BP) STI571 with 1 to 2 courses of chemotherapy hematology CR2 cases, PR3 cases, the total effective rate was 83% (5/6), cytogenetics CR1 cases, 3 cases of cytogenetic improvement. Of the 4 patients treated with STI571, allogeneic HSCT were performed in 3 patients and autologous HSCT was performed in 1 patient. Two patients survived to this day and the other two patients died of severe hepatitis and leukemia recurrence. Conclusion STI571 monotherapy is effective in all stages of CML, and is superior to CML-AP and CML-BP in patients with CML-CP. Chemotherapy can not improve the efficacy of STI571 in patients with CML-AP and BP. STI571 in HSCT transplantation does not affect hematopoietic reconstitution.