Comparative Analysis of Efficacy and Drug Resistance of Imatinib in Patients with Chronic Myeloid Leukemia at Chronic and Advanced Phases / 中国实验血液学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare the efficacy and drug resistance of imatinib in patients with chronic myeloid leukemia (CML) at chronic phase (CP) and advanced phase (accelerated phase and blast crisis (AP+BC).</p><p><b>METHODS</b>Forty-two patients with CML were treated with imatinib of different doses(CP 400 mg/d, AP+BC 600 mg/d), and the efficacy and drug resistance of the 2 groups were compared. The median follow-up time was 24 months (3-42 months).</p><p><b>RESULTS</b>The complete hematological remission rate (CHR), the major cytogenetic remission rate (MCyR) and complete molecular remission rate (CMoR) in the CP group were 100%, 89.6% and 20.1% respectively, while those in advanced phase group were 46.2%, 308% and 0; survival rate of 42 months in CP patients was 76.7%, and that in advanced phase group was 39.2%, the difference between them was statistically significant (P<0.05). The incidence of severe hematologic adverse reaction in advanced phase group was higher than that in CP Group; among 42 cases of CML, the drug-resistance happened in 13 cases, out of them 9 cases was CML in advanced phase; the drug resistance rate in CML in advanced phase group (69.2%) was significantly higher than that in CML-CP group(13.8%). The correlation factor analysis showed that the effects of the advanced phase and the lower dose of the drug were statistically significant.</p><p><b>CONCLUSION</b>Imatinib can provide certain curative effect for CML patients at different phases, especially for the patients at chronic phase; the early MCyR for patients with CML is an important factor in long-term survival; drug resistance is an important factor affecting the efficacy of imatinib; The incidence of imatinib drug resistance at the late stage has been found to be higher.</p>