Clinical Efficacy Of Imatinib Meylate In Treatment Of Patients With Chronic Myeloid Leukemia In Advanced Phase

Objective: To observe the efficacy of imatinib mesylate in the treatment of patients with chronic myeloid leukemia (CML) in advanced phase which including accelerated phase and blast crisis. Methods: There were 12 advanced phase CML patients in the imatinib treatment group, including 6 patients in accelerated phase (AP) and 6 patients in blast crisis (BC). The prescribed dose was administrated, 600mg 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 bcr/abl fusion-gene detection. Dose was adjusted from time to time according to the the results of blood examination and the patients tolerance to the drug. There were 19 CML patients in the historical control group, including 9 patients in accelerated phase and 10 patients in blast phase (including 4 cases with acute lymphoblastic leukemia and 6 cases with acute myelogenous leukemia, 1 case turned to acute lymphoblastic leukemia in the later phase). This group achieved a combination chemotherapy: The patients in accelerated phase and acute myelogenous leukemia achieved HOAP, HA,TA,THA,DA,EA,EM; The patients whith acute lymphoblastic leukemia achieved combination chemotherapy of VDCP,VDP,VMP,VTCP,COMP ; chemotherapy was adjusted from time to time according to result of blood and bone marrow examination. Results: Three patients of imatinib treatment group achieved complete hematologic remission(CHR), including 2 cases (16.7%) whose Ph chromosome and bcr/abl fusion-gene turned negative after treatment; 1 of 12(8.3%) returned to chronic phase; 2 of 12(16.7%) achieved partial hematologic remission (PHR); 7 of 12(58.3%) still remain no remission(NR). Total hematologic response rate of imatinib treatment group was 41.7%. One of 19 (5.3%) patients of historical control group achieved CHR, another eighteen patients still remain NR; Total hematologic response rate of historical control group was 5.3%, significantly lower than that of imatinib treatment group(P<0.05). Toxicity of imatinib is not serious, and easy to tolerate. Conclusions: Imatinib mesylate demonstrates better therapeutic effect in the treatment of CML in advanced phase than traditional chemotherapy with comparatively mild toxity, patients have a good tolerance to imatinib.