伊马替尼联合 Hyper-CVAD 方案治疗 Ph 染色体阳性急性淋巴细胞白血病的临床观察

摘要

目的：观察伊马替尼联合环磷酰胺+长春新碱+吡柔比星+地塞米松或甲氨蝶呤+阿糖胞苷(Hyper-CVAD)方案治疗 Ph 染色体阳性急性淋巴细胞白血病(Ph+-ALL)患者的临床疗效及安全性。方法我院血液科应用伊马替尼联合 Hyper-CVAD 方案治疗16例 Ph+-ALL 患者，治疗方案为伊马替尼联合 Hyper-CVAD(A/B 方案)序贯治疗，持续8个疗程，伊马替尼维持治疗24个月。结果16例患者血液学完全缓解率(HCR)为100%，患者1、2、3年总生存率(OS)分别为(87.1±8.6)%、(72.3±11.9)%和(63.3±13.4)%。不良反应主要为Ⅳ度骨髓抑制，非血液学不良反应均为Ⅰ~Ⅱ度。结论伊马替尼联合 Hyper-CVAD 方案治疗 Ph 染色体阳性急性淋巴细胞白血病的临床疗效满意，不良反应可以耐受。%Objective To report the efficacy and safety of imatinib combined with Hyper-CVAD chemotherapy regimen in the treatment of patients with Philadelphia chromosome positive acute lymphoblastic leukemia(Ph+ ALL). Methods A sequential 24-month and 8-cycle treatment of imatinib combined with Hyper-CVAD(A/B program)was administrated in 1 6 Ph+ ALL patients treated at our hospital.Results In 1 6 cases,the overall response rate was 100%.And the 1-,2-and 3-year overall survival rates were (87.1 ±8.6)%,(72.3 ±1 1.9)% and (63.3 ±13.4)%, respectively.The most common adverse reaction was bone marrow suppression.Conclusion Imatinib combined with Hyper-CVAD regimen can achieve a satisfactory result in the treatment of patients with Philadelphia chromosome positive acute lymphoblastic leukemia,and the toxicity can be tolerable.