摘要
目的探究达沙替尼治疗原发性骨髓纤维化(PMF)的有效性及安全性。方法共纳入2015-06-01至2017-10-01就诊于河南省7所医院的21例PMF患者,男8例,女13例,中位年龄65岁,口服达沙替尼50 mg,每日2次。用脾脏Ⅰ线长度评估脾脏大小,骨髓增殖性肿瘤(MPN)10症状评分表对患者进行症状评分。结果 21例患者中,17例在达沙替尼治疗1周后观察到显著的脾脏回缩,治疗5～8周达到较稳定的缩脾状态,脾脏较基线缩小2/3左右;3例分别在使用达沙替尼治疗16、18、19周后,骨髓纤维化程度由3级降至1级;达沙替尼治疗前21例患者MPN10症状评分的中位数为32.00 (28.50,38.50),治疗后为23.00 (17.5,28.5),达沙替尼治疗后MPN10症状评分较治疗前明显下降;患者治疗过程中尚未观察到细胞遗传学效应。达沙替尼治疗过程中的不良事件包括贫血、血小板减低、体液潴留、电解质紊乱、疲劳、感染等,发生率>40%,仅有2例因出现心包积液所致呼吸困难而停药。结论达沙替尼治疗对PMF患者有效,其疗效主要表现在缩小脾脏体积、改善生活质量、部分逆转骨髓纤维化,有望恢复骨髓造血,常见的不良反应多为1～2级,多可耐受。
Objective To explore the efficacy and safety of dasatinib in the treatment of patients with primary myelofibrosis(PMF). Methods A total of 21 patients with PMF treated in multicenter were included,8 men and 13 women,with a median age of 65 (48- 78)years.Patients were administered 50 mg of dasatinib twice a day.The splenomegaly measurement was represented by line"1".The Myeloproliferative Neoplasm Symptom Assessment Form (MPN10)was used to assess the symptoms.Results After an average of 1 week of dasatinib treatment,17 of the 21 patients were observed significant shrinkage of the spleen volume,.and the spleen volume reached a stable state in the 5-8 weeks,a reduction of about 2/3 in spleen volume compared to the baseline value.After 16 weeks,18 weeks and 19 weeks of dasatinib treatment,the degree of myelofibrosis in 3 patients was reduced from grade 3 to grade 1.The median MPN10 symptom score of 21 patients was 32.00 (28.50,38.50)before treatment and 23.00 (17.5,28.5)after treatment.MPN10 symptom score was significantly lower after dasatinib treatment.Cytogenetic responses had not been observed during the treatment. Adverse events with a incidence of more than 40% in the course of dasatinib treatment included anemia,thrombocytopenia,fluid retention,electrolyte disorders,fatigue,infection and so on,only 2 patients stopped taking drugs due to dyspnea caused by pericardial effusion.Conclnsion Dasatinib was effective in the treatment of PMF.The therapeutic effects of dasatinib were mainly manifested in reducing the volume of the spleen,improving the quality of life and partly reversing the myelofibrosis,bone marrow hematopoiesis was expected to be restored.Most of the common adverse reactions were grade 1-2 and could be tolerated.
作者
宋庆林
程诗佳
张贝
江梅
裴智信
徐倩文
路晓辉
李文永
李中东
刘峥嵘
尹振东
匡霞
党惠兵
张琰
邹典斌
SONG Qing-lin;CHENG Shi-jia;ZHANG Bei;JIANG Mei;PEI Zhi-xin;XU Qjan-wen;LU Xiao-hui;LI Wen-yong;LI Zhong-dong;LIU Zheng-rong;YIN Zhen-dong;KUANG Xia;DANG Hui-bing;ZHANG Yan;ZOU Dian-bin(The People's Hospital of Jiaozuo,Jiaozuo 454100, China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2018年第12期1181-1184,共4页
Chinese Journal of Practical Internal Medicine
