本文選題：兒童 + 慢性粒細(xì)胞白血病��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過回顧性分析兒童慢性粒細(xì)胞白血病患兒的臨床資料,探討甲磺酸伊馬替尼對(duì)于治療兒童慢性粒細(xì)胞白血病的近期療效及安全性,比較進(jìn)口藥格列衛(wèi)與國(guó)產(chǎn)藥昕維的安全性及療效差異。方法:對(duì)廣西醫(yī)科大學(xué)第一附屬醫(yī)院兒科在2012年3月-2016年11月收治的12例兒童慢性粒細(xì)胞白血病患兒的臨床資料進(jìn)行回顧性分析,隨訪時(shí)間為接受甲磺酸伊馬替尼治療后1周至2017年3月,觀察治療不同時(shí)期的臨床表現(xiàn)、血常規(guī)、骨髓細(xì)胞形態(tài)學(xué)、骨髓染色體、BCR/ABL融合基因等情況,參照NCCN制定的慢性期治療反應(yīng)的定義及中國(guó)伊馬替尼療效標(biāo)準(zhǔn)對(duì)療效進(jìn)行判定;回顧并比較兩組患兒血常規(guī)、肝腎功能情況;應(yīng)用SPSS21.0統(tǒng)計(jì)學(xué)軟件對(duì)格列衛(wèi)組和昕維組外周血、骨髓細(xì)胞形態(tài)學(xué)達(dá)到完全血液學(xué)反應(yīng)的時(shí)間分別進(jìn)行統(tǒng)計(jì)學(xué)分析,比較兩者療效及安全性差異。結(jié)果:1.12例慢性粒細(xì)胞白血病患兒均為慢性期,男女比率為1.4:1,診斷及開始治療的中位年齡為6歲。2.12例患兒在伊馬替尼治療后3個(gè)月臨床癥狀、血常規(guī)達(dá)到完全血液學(xué)反應(yīng),3例患兒在治療后3個(gè)月骨髓細(xì)胞形態(tài)學(xué)達(dá)到完全血液學(xué)反應(yīng),8例患兒在3個(gè)月-17個(gè)月間達(dá)到完全血液學(xué)反應(yīng)標(biāo)準(zhǔn),1例患兒未復(fù)查骨髓細(xì)胞形態(tài)學(xué)。3.4例患兒達(dá)到完全分子生物學(xué)反應(yīng),1例達(dá)到主要分子生物學(xué)學(xué)反應(yīng),6例患兒達(dá)到完全血液學(xué)反應(yīng),1例患兒外周血達(dá)到完全血液學(xué)反應(yīng)標(biāo)準(zhǔn)。4.隨訪中發(fā)現(xiàn)患兒有頭暈、惡心、鼻衄、關(guān)節(jié)疼痛癥狀;治療過程中12例患兒均無骨髓抑制及肝腎功能損害表現(xiàn)。5.12例患兒中有6例口服格列衛(wèi),6例口服昕維,以SPSS 21.0對(duì)兩組進(jìn)行比較,年齡(P=0.907)、用藥劑量(起始量P=0.193;維持量P=0.949)、外周血達(dá)到完全血液學(xué)反應(yīng)標(biāo)準(zhǔn)的時(shí)間(P=0.936)無統(tǒng)計(jì)差異,骨髓細(xì)胞形態(tài)學(xué)達(dá)到完全血液學(xué)反應(yīng)標(biāo)準(zhǔn)的時(shí)間有統(tǒng)計(jì)學(xué)差異(P=0.004),昕維組較格列衛(wèi)組能更快達(dá)到骨髓細(xì)胞學(xué)完全緩解。結(jié)論:1.甲磺酸伊馬替尼對(duì)于治療慢性期兒童慢性粒細(xì)胞白血病有較好的近期療效及安全性。2.格列衛(wèi)與昕維對(duì)兒童慢性粒細(xì)胞白血病的療效和安全性無顯著差異。
[Abstract]:Objective: to study the efficacy and safety of imatinib mesylate in the treatment of chronic myeloid leukemia in children. To compare the safety and curative effect difference between imported drug Glevir and domestic drug Xinwei. Methods: the clinical data of 12 children with chronic myeloid leukemia admitted in pediatrics department of the first affiliated Hospital of Guangxi Medical University from March 2012 to November 2016 were retrospectively analyzed. The follow-up period was from 1 week to March 2017 after treatment with imatinib mesylate. The clinical manifestations, blood routine examination, bone marrow cell morphology, bone marrow chromosome BCR / ABL fusion gene and so on were observed. According to the definition of chronic stage therapy reaction established by NCCN and the Chinese standard of imatinib curative effect, the curative effect was judged, the blood routine, liver and kidney function of the two groups were reviewed and compared, and the peripheral blood of Glewei group and Xinwei group were analyzed by SPSS21.0 software. The time of complete hematological response of bone marrow cells was statistically analyzed to compare the efficacy and safety of the two methods. Results the ratio of male to female was 1.4: 1. The median age of diagnosis and treatment was 6 years old. 2. 12 cases had clinical symptoms 3 months after treatment with imatinib. Blood routine reached complete hematological response in 3 children with bone marrow cell morphology reached complete hematological response in 3 months after treatment. 8 cases reached complete hematological response standard in 3 to 17 months. Medullary morphology. 3.4 cases of children achieved complete molecular biological response and 1 case of major molecular biological reaction. 6 cases of children with complete hematological response and 1 case of peripheral blood reached the standard of complete hematological reaction .4. During the follow-up, dizziness, nausea, epistaxis and joint pain were found in the children. SPSS 21.0 was used to compare the two groups. There was no statistical difference between the two groups in terms of age, dosage (initial dose P0. 1993; maintenance dose: P0. 949; time for peripheral blood to reach the standard of complete hematological response, P 0. 936). The time of bone marrow cell morphology reaching the standard of complete hematological reaction was significantly different (P0. 004), and the complete remission of bone marrow cytology in Xinwei group was faster than that in Gliewei group. Conclusion 1. Imatinib mesylate has good short-term efficacy and safety in the treatment of chronic myeloid leukemia in children. There was no significant difference in efficacy and safety between Gliewei and Xinwei in the treatment of chronic myeloid leukemia in children.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R733.72

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 曾慧敏;張樂萍;;兒童慢性粒細(xì)胞白血病臨床特點(diǎn)及治療進(jìn)展[J];中華臨床醫(yī)師雜志(電子版);2016年11期

2 李菲;張曉潔;張榮艷;肖承京;盧煒;饒佳;周玉蘭;陳國(guó)安;楊贛萍;;伊馬替尼一線治療慢性粒細(xì)胞白血病慢性期患者-單中心十年回顧性分析[J];中國(guó)腫瘤臨床;2016年10期

3 祝文娟;尹大偉;李琚;江娟;;國(guó)產(chǎn)甲磺酸伊馬替尼片治療慢性粒細(xì)胞白血病的臨床觀察[J];中國(guó)藥房;2016年05期

4 董毅;朱太崗;李月紅;曾慶曙;夏瑞祥;葛健;馬圣宇;;國(guó)產(chǎn)伊馬替尼治療慢性髓細(xì)胞白血病有效性和安全性分析[J];淮海醫(yī)藥;2016年01期

5 吳晶晶;丁亦含;衛(wèi)彬;李玉峰;;三氧化二砷在慢性髓細(xì)胞白血病中的研究進(jìn)展[J];臨床血液學(xué)雜志;2015年06期

6 李珊珊;蔣慧;;伊馬替尼治療兒童慢性髓細(xì)胞性白血病效果分析[J];上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2015年01期

7 苗圣超;糜堅(jiān)青;;慢性粒細(xì)胞白血病對(duì)伊馬替尼的耐藥機(jī)制研究進(jìn)展[J];中國(guó)臨床醫(yī)學(xué);2014年06期

8 高星辰;黃炎清;丁家華;;在酪氨酸激酶抑制劑時(shí)代異基因造血干細(xì)胞移植治療進(jìn)展期CML的角色變化[J];現(xiàn)代醫(yī)學(xué);2014年03期

9 李夢(mèng)醒;王季石;張燕;孫志強(qiáng);趙鵬;盧英豪;;伊馬替尼聯(lián)合干細(xì)胞移植治療慢性粒細(xì)胞白血病臨床觀察[J];重慶醫(yī)學(xué);2013年29期

10 展文國(guó);;裴正學(xué)教授用補(bǔ)腎健脾扶正固本法治療慢性粒細(xì)胞性白血病經(jīng)驗(yàn)特色[J];新中醫(yī);2013年03期

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