文章：

老年慢性髓性白血病的伊马替尼间歇治疗管理

Managing chronic myeloid leukaemia in the elderly with intermittent imatinib treatment

原文发布日期：2015-09-18

DOI: 10.1038/bcj.2015.75

类型: Original Article

开放获取: 是

英文摘要：

The aim of this study was to investigate the effects of a non-standard, intermittent imatinib treatment in elderly patients with Philadelphia-positive chronic myeloid leukaemia and to answer the question on which dose should be used once a stable optimal response has been achieved. Seventy-six patients aged ⩾65 years in optimal and stable response with ⩾2 years of standard imatinib treatment were enrolled in a study testing a regimen of intermittent imatinib (INTERIM; 1-month on and 1-month off). With a minimum follow-up of 6 years, 16/76 patients (21%) have lost complete cytogenetic response (CCyR) and major molecular response (MMR), and 16 patients (21%) have lost MMR only. All these patients were given imatinib again, the same dose, on the standard schedule and achieved again CCyR and MMR or an even deeper molecular response. The probability of remaining on INTERIM at 6 years was 48% (95% confidence interval 35–59%). Nine patients died in remission. No progressions were recorded. Side effects of continuous treatment were reduced by 50%. In optimal and stable responders, a policy of intermittent imatinib treatment is feasible, is successful in about 50% of patients and is safe, as all the patients who relapsed could be brought back to optimal response.

摘要翻译： 

本研究旨在探讨非标准化间歇性伊马替尼治疗方案对费城染色体阳性慢性髓系白血病老年患者的疗效，并解答当患者达到稳定最佳反应后应使用何种剂量的问题。研究纳入76例年龄≥65岁、经标准伊马替尼治疗≥2年且达到稳定最佳反应的患者，测试间歇性伊马替尼方案（INTERIM方案：用药1个月/停药1个月）。经过至少6年随访，16/76例（21%）患者失去完全细胞遗传学反应（CCyR）和主要分子学反应（MMR），另有16例（21%）仅失去MMR。所有复发患者再次接受相同剂量的标准方案伊马替尼治疗后，均重新获得CCyR和MMR或达到更深层次的分子学反应。6年内维持INTERIM方案治疗的概率为48%（95%置信区间35-59%）。9例患者在缓解期死亡，无病例出现疾病进展。持续治疗的副作用减少50%。对于达到稳定最佳反应的患者，间歇性伊马替尼治疗策略具有可行性，约50%患者治疗成功且安全性良好，所有复发患者均能重新达到最佳反应状态。

原文链接：

Managing chronic myeloid leukaemia in the elderly with intermittent imatinib treatment