The Curative Effect Of Chronic Myeloid Leukemia With Marrow Fibrosis Clinical Observation

Objective: To observe the curative effect of imatinib and other TKI drugs on chronic myeloid leukemia(CML)patients with myelofibrosis.Methods: From March 2014 to October 2017,136 patients with chronic myeloid leukemia(CML-CP)at the outpatient department of hematology of a hospital in anhui province were collected and treated with imatinib at the first treatment.According to the grading standards of myelofibrosis in Europe,the degree of myelofibrosis was divided into 3 groups: 65 cases of myelofibrosis(-/+),40 cases of myelofibrosis(++),and 31 cases of myelofibrosis(+++).Oral Imatinib once per day,400 mg each time,12 months after discontinuation of treatment,the examination of the bone marrow puncture,improve bone marrow cytology,BCR-ABLIS transcription,chromosome karyotype and bone marrow pathology examination,at the same time from the start when taking medicine,improve the blood routine,liver and kidney function regularly and other biochemical function and electrocardiogram examination,observation of three groups of patients with Imatinib therapy in December after the main molecular biology reaction gain rate,the BCR-ABLIS 0.1% or less and from medicine appeared at the beginning of adverse reactions.Results: In terms of the main molecular biological response(MMR),the bone marrow fibrosis(-/+)group had a significantly higher acquisition rate than the bone marrow fibrosis(++)and(+++)groups,respectively 84.62%,65.00% and 54.84%.According to the toxicity standard classification of NCI/NIH,in terms of drug-related adverse reactions,most of the patients in the three groups had grade i-ii adverse reactions,which were mostly self-limited,and grade iii-iv adverse reactions were rare.The incidence of hematological toxicity and other adverse reactions in the bone marrow fibrosis(-/+)group was significantly lower than that in the bone marrow fibrosis(++)and bone marrow fibrosis(+++)groups(32.31%,47.50% and 74.19%,respectively).Conclusion: Chronic myeloid leukemia(CML-CP)patients without obvious myelofibrosis can achieve more major molecular biological remission,and the incidence of hematological toxicity and other adverse reactions is low.