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Clonal evolution of abnormal Philadelphia chromosome-negative cells after imatinib mesylate therapy in patients with Philadelphia chromosome-positive chronic myelogenous leukemia
Author(s): 
Pages: 23-26
Year: Issue:  1
Journal: CHINESE JOURNAL OF HEMATOLOGY

Keyword:  白血病髓样慢性费城染色体伊马替尼;
Abstract: 目的观察Ph阳性慢性粒细胞白血病(Ph+CML)患者在伊马替尼治疗后的Ph阴性异常克隆演变(Ph-CE).方法对100例伊马替尼单药治疗有效的Ph+CML患者(其中干扰素治疗失败的慢性期患者54例、加速期患者37例、急变期患者9例)在治疗前及治疗后18~30个月内定期监测其细胞染色体核型变化(G显带方法).结果11例(11%)患者于治疗后3~29个月一过性、间断或连续检出Ph-CE,其中慢性期患者5例、加速期患者5例、急变期患者1例.Ph-CE见于Ph+克隆开始减少时或在Ph+克隆消失之后,同期Ph-CE细胞的比例与Ph+细胞的比例呈负相关(P<0.05).Ph-CE多为+8(5例,45.5%)和+Y(3例,27.3%),5例患者同时伴有Ph+细胞染色体附加异常.Ph-CE者中,7例获得主要遗传学缓解,9例获得完全血液学缓解.在观察期内,1例加速期患者在持续治疗20个月时进展至急变期.结论Ph+CML患者经伊马替尼治疗后获得不同程度遗传学缓解时约11%被检出Ph-CE,但在随访期内大多数患者未显示病情进展.
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