Clinical Research In 50 Patients With Chronic Myeloid Leukemia Treated With Imatinib Mesylate

Objective To observe the efficacy and safety of imatinib mesylate(IM) for treat ment of Philadelphia chro mosome positive(Ph) and(or) BCR/ABL Fusion gene positive chronic myeloid leukemia in chronic phase(CML-CP).Methods We reviewed 50 CML-CP patients who were treated with IM 400mg/day at the general hospital of Ningxia Medical University from September 2006 to February 2015. During treatment, blood cell count, bone marrow cell genetics, cytogenetic and molecular effects were reviewed. IM doses adjusted according to these results and the Patients,tolerance.Results In the 50 CML-CP patients, the median treatment time was 30 months(range,5-101 months), male: female incidence ratio for 13: 12, the median age of these patients was 43 years(range,14-73 years). The results showed:1. The cumulative complete hematological respond(CHR),major cytogenetic response(MCy R),complete cytogenetic response(CCy R),major molecular response(MMR),complete molecular response(CMR)rates were 96%,90%,75%,58%,46%. 2. The 1-year progression-free survival(PFS) and event free survival(EFS) in the patients were 97.8% and 93.9%. The 5-year PFS and EFS were 87% and 78%.3. In the treatment process, hematology adverse reactions were leukocytes and platelets reduced. grade I, grade II,grade III, grade IV rates were 36%,20%,8%,4%.The no-hematology adverse reactions were edema( 82%),nausea and(or) vomiting patients(62%), rash and(or) itching and other allergic reactions(26%), muscle and joint pain(28%), pericardial effusion(2%).Conclusion 1. In CML-CP patients, Imatinib mesylate can achieve a high major cytogenetic response rate and major molecular response rate, prolong EFS and PFS and improve the life quality. 2. The treatment with IM 400mg/day in CML-CP patients can be tolerated. The main adverse reactions are cytopenias and edema. Most of the patients can tolerate after adjusting the drug dosage and receiving symptomatic treatments. A few intolerant patients achieve remission taking the two generation tyrosine kinase inhibitors. 3. Monitoring the changes of periodic hematologic, cytogenetic and molecular in CML-CP patients treated with IM regularly, can detect failure in the treatment of patients early. Timely change the treatment program can improve the curative effect.