Zhonghua nei ke za zhi · 2003
[The early efficacy of imatinib in the treatment of 54 cases of chronic myeloid leukemia].
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Lou Fang-ding, Lu Xue-chun
Аннотация
OBJECTIVE: To observe the early outcome of imatinib in the treatment of chronic myeloid leukemia (CML).
METHODS: There were 54 CML patients including 17 patients in chronic phase (CP), 13 patients in accelerated phase (AP) and 24 patients in blast crisis (BC). The dosage of imatinib is 400 mg/day for CP patients and 600 mg/day for AP and BC patients. The prescribed dose was administrated orally, once daily after a meal with a large glass of water. Before starting the imatinib administration, all the patients had thorough physical examination as well as blood and bone marrow examination, Ph chromosome and or the bcr/abl fusion-gene detection. Blood picture was examined twice a week in the first month of administration and thereafter weekly or fortnightly in the following days. Hepatic and renal function was tested fortnightly or every four weeks. Patients had bone marrow examination, Ph chromosome and or the bcr/abl fusion-gene detection again when they achieved a hematological response (CR). Dose was adjusted from time to time according to the results of blood examination and the patients tolerance to the drug.
RESULTS: After a median 5-month period of follow-up, all the 17 CP patients achieved complete hematological response, including 6 cases (35.2%) whose Ph chromosome turned negative after treatment. 8 (61.5%) out of the 13 AP patients and 9 (37.5%) out of the 24 BC patients returned to chronic phase respectively. Adverse events included myelosuppression, periorbital edema or edema of the lower limbs, myalgia and muscle cramps, nausea, vomiting, low fever, tetter and bilirubin increasing.
CONCLUSIONS: imatinib has good early efficacy in the treatment of CML and the therapeutic result is the best in the CP patients, next in the AP patients and relatively poor in the BP patients. The long term outcome of imatinib needs further observation. Patients have a good tolerance to imatinib.
METHODS: There were 54 CML patients including 17 patients in chronic phase (CP), 13 patients in accelerated phase (AP) and 24 patients in blast crisis (BC). The dosage of imatinib is 400 mg/day for CP patients and 600 mg/day for AP and BC patients. The prescribed dose was administrated orally, once daily after a meal with a large glass of water. Before starting the imatinib administration, all the patients had thorough physical examination as well as blood and bone marrow examination, Ph chromosome and or the bcr/abl fusion-gene detection. Blood picture was examined twice a week in the first month of administration and thereafter weekly or fortnightly in the following days. Hepatic and renal function was tested fortnightly or every four weeks. Patients had bone marrow examination, Ph chromosome and or the bcr/abl fusion-gene detection again when they achieved a hematological response (CR). Dose was adjusted from time to time according to the results of blood examination and the patients tolerance to the drug.
RESULTS: After a median 5-month period of follow-up, all the 17 CP patients achieved complete hematological response, including 6 cases (35.2%) whose Ph chromosome turned negative after treatment. 8 (61.5%) out of the 13 AP patients and 9 (37.5%) out of the 24 BC patients returned to chronic phase respectively. Adverse events included myelosuppression, periorbital edema or edema of the lower limbs, myalgia and muscle cramps, nausea, vomiting, low fever, tetter and bilirubin increasing.
CONCLUSIONS: imatinib has good early efficacy in the treatment of CML and the therapeutic result is the best in the CP patients, next in the AP patients and relatively poor in the BP patients. The long term outcome of imatinib needs further observation. Patients have a good tolerance to imatinib.