本文關(guān)鍵詞：尼洛替尼、伊馬替尼治療慢性髓細胞白血病療效的Meta分析　出處：《昆明醫(yī)科大學》2016年碩士論文　論文類型：學位論文

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【摘要】：[目的]系統(tǒng)評價尼洛替尼(Nilotinib) 300/400mg twice daily與伊馬替尼(Imatinib)400mg once daily治療六個月內(nèi)新診斷的費城染色體陽性的慢性期的慢性髓細胞白血病(Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP)的療效,及尼洛替尼(Nilotinib) 300mg twice daily與尼洛替尼(Nilotinib) 400mg twice daily治療六個月內(nèi)新診斷的費城染色體陽性的慢性期的慢性髓細胞白血病(Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP)的療效。[方法]計算機檢索The Cochrane Library(2014年第9期)、MEDLINE、PubMed、 EMbase、Ovid, CBM、CNKI、VIP和WanFang Data,同時手工檢索相關(guān)期刊,收集尼洛替尼與伊馬替尼治療六個月內(nèi)新診斷的費城染色體陽性的慢性期的慢性髓細胞白血病(Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP)的RCT。所檢索文章時限自建庫至2014年11月1日。對符合納入標準的RCT,由兩位研究者獨立評價納入文獻質(zhì)量,而后交叉核對,采用RevMan 5.2軟件進行Meta分析,采用StataSE12.0軟件進行敏感性分析。[結(jié)果]納入的4篇文獻中,共有2617例患者。Meta分析結(jié)果顯示,尼洛替尼300mg twice daily vs伊馬替尼400mg, once daily長期治療Ph+CML-CP時,兩者主要分子學反應(yīng)(Major Molecular Response, MMR), [RR=1.76,95% Cl(1.54,2.01),P=0.22]、完全分子學反應(yīng)(complete molecular response with a 4 log reduction or greater, CMR4) [RR=2.02,95%Cl(1.68,2.41), P=0.51]差異有統(tǒng)計學意義；尼洛替尼400mg twice daily vs伊馬替尼400mg, once daily長期治療Ph+CML-CP時,兩者主要分子學反應(yīng)(Major Molecular Response, MMR), [RR=1.68,95% Cl(1.47,1.92), P=0.18]、完全分子學反應(yīng)(complete molecular response with a 4 log reduction or greater, CMR4) [RR=1.75,95% Cl(1.45,2.10), P=0.34]差異有統(tǒng)計學意義；尼洛替尼300mg twice daily vs尼洛替尼400mg twice daily長期治療Ph+CML-CP時,主要分子學反應(yīng)(Major Molecular Response, MMR)[RR=0.89, 95%Cl(0.86,1.05), P=0.90]、完全分子學反應(yīng)(complete molecular response with a4 log reduction or greater, CMR4) [RR=0.87,95% Cl(0.76,1.00), P= 1.00],差異無統(tǒng)計學意義。[結(jié)論]對六個月內(nèi)新診斷的費城染色體陽性的CP-CML療效評價中,尼洛替尼300/400mg twice daily優(yōu)于伊馬替尼400mg once daily,尼洛替尼300mg twicedaily與尼洛替尼400mg twice daily無差別。
[Abstract]:[Objective] the evaluation system of nilotinib (Nilotinib) 300/400mg twice daily with imatinib (Imatinib) 400mg once daily within six months of treatment of newly diagnosed Philadelphia chromosome positive chronic phase chronic myeloid leukemia (Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP) and the efficacy of nilotinib (Nilotinib 300mg twice daily) and nilotinib (Nilotinib) 400mg twice daily within six months of treatment of newly diagnosed Philadelphia chromosome positive chronic phase chronic myeloid leukemia (Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP) effect. [method] the computer retrieval The Cochrane Library (2014 ninth), MEDLINE, PubMed, EMbase, Ovid, CBM, CNKI, VIP and WanFang Data, while the manual retrieval of relevant journals, collecting nilotinib and imatinib therapy within six months of newly diagnosed Philadelphia chromosome positive chronic phase chronic myeloid leukemia (Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP RCT). The time limit for the retrieved articles is from the establishment of the library to November 1, 2014. According to the inclusion criteria of RCT, two researchers independently evaluated the quality of the included literature. Then the cross check was performed. RevMan 5.2 software was used for Meta analysis, and StataSE12.0 software was used for sensitivity analysis. [results] of the 4 documents included, there were 2617 patients. The results of Meta analysis showed that 300mg twice daily vs nilotinib and imatinib 400mg, once daily Ph+CML-CP for the long-term treatment, two major molecular response (Major Molecular, Response, MMR), [RR=1.76,95% Cl (1.54,2.01), P=0.22] (complete molecular, complete molecular response response with a 4 log reduction or greater CMR4 [RR=2.02,95%Cl (1.68,2.41)), there were significant differences in P=0.51]; 400mg twice daily vs nilotinib and imatinib 400mg, once daily Ph+CML-CP for the long-term treatment, two major molecular response (Major Molecular, Response, MMR), [RR=1.68,95% Cl (1.47,1.92), P=0.18], complete molecular response complete molecular response (with a 4 log reduction or greater, CMR4 [RR=1.75,95% Cl) (1.45,2.10), there were significant differences in P=0.34]; 300mg twice daily vs nilotinib nilotinib 400mg twic E daily for long-term treatment of Ph+CML-CP, a major molecular response (Major Molecular, Response, MMR) [RR=0.89, 95%Cl (0.86,1.05), P=0.90] (complete molecular, complete molecular response response with A4 log reduction or greater, CMR4) [RR=0.87,95% Cl (0.76,1.00), P= 1.00], the difference was not statistically significant. [Conclusion] the evaluation of six months of newly diagnosed Philadelphia chromosome positive CP-CML effect, 300/400mg twice daily is better than that of nilotinib and imatinib mesylate for 400mg once daily, 300mg twicedaily and nilotinib nilotinib 400mg twice daily no difference.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R733.72

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