Efficacy And Safety Of High Dose Imatinib In Chronic Myeloid Leukemia Of The Meta-analysis

Objective:To systematically evaluate the efficacy and safety of high-dose imatinib (IM) and standard-dose imatinib in chronic myeloid leukemia (CML).Methods:The randomized controlled trials(RCTs)were retrieved from PubMed, The Cochrane Library (issue 3,2013), EMbase, Superstar Medalink, CBM, Wanfang Database, CNKI, VIP and other databases, and retrospective references included in the study, randomized controlled trials for inclusion by two reviewers according to Cochran risk of bias assessment tool for quality assessment. Using RevMan 5.2 software for Meta-analysis.Results:A total of six randomized controlled trials,2,045 cases of chronic myeloid leukemia in chronic phase patients. Meta-analysis results showed that:high-dose compared with low-dose IM, complete cytogenetic response (CCyR)at 6 and 12 months rate:(RR=1.34,95% CI:0.73～5.90, P<0.00001); (RR=1.16,95% CI:1.07～1.25, P =0.0003),3,6,12 months, major molecular response (MMR) rate:(RR=2.97,95% CI: 1.75～5.05, P<0.0001); (RR=2.02,95% CI:1.38～2.93, P=0.0003); (RR=1.28,95% CI:1.14～1.44, P<0.0001), progression-free survival (PFS) rate:(RR=1.04,95% CI: 1.00～1.09, P=0.04), the differences were statistically significant. The adverse events of high dose group was higher than the standard dose group (RR=1.98,95% CI:1.20～ 3.26, P<0.01), the two groups neutropenia and thrombocytopenia rates were:(RR=1.55, 95% CI:0.76-2.35, P=0.006); (RR=2.98,95% CI:1.28-2.86, P=0.001).Conclusion:High-dose imatinib effective than standard -dose group, but the adverse events was higher than the standard -dose group, by the quality and quantity restrictions included in the study, these conclusions have yet to be carried out more high-quality large randomized double-blind clinical samples controlled trials to prove.