[Clinical Efficacy of Second-generation Tyrosine Kinase Inhibitor in Treating Chronic Myeloid Leukemia].

OBJECTIVE: To evaluate the efficacy of second-generation tyrosine kinase inhibitor (TKI) in treating chronic myeloid leukemia (CML). METHODS: A total of 97 patients with CML were enrolled. The patients were treated with TKI and monitored with complete blood count, cytogenetic and molecular indicators during the course of therapy. Survival analysis was performed to evaluate its clinical efficacy. RESULTS: The treatment achieved 97.9% complete hematologic response (CHR), 63.9% major cytogenetic response (MCyR), 60.0% complete cytogenetic response (CCyR) and 44.3% major molecular response (MMR) rates. Apart from CHR, better effects were shown in those indicators during chronic phase compared with progressive phase (P < 0.05). The 1-year, 2-year, 3-year and 5-year overall survival (OS) rate was (90.6 ± 3.0)%, (80.1 ± 4.5)%, (77.5 ± 5.0)% and (64.6 ± 9.3)%, respectively, compared with an event-free survival (EFS) rate of (81.1 ± 4.0)%, (64.4 ± 5.3)%, (56.4 ± 6.0)% and (46.2 ± 8.2)%, respectively. The patients had a 1-year, 2-year, 3-year and 5-year progession-free survival (PFS) rate of (87.4 ± 3.4)%, (73.2 ± 4.9)%, (68.9 ± 5.5)% and (57.4 ± 8.7)%, respectively. A difference between chronic phase (better results) and progressive phase (P < 0.05) was also found in survival indicators. The first-line TKI therapy had 100% CHR, 95% MCyR, 95% CCyR and 70% MMR, compared with 97.3% CHR, 56.8% MCyR, 48.6% CCyR and 36.5% MMR for the second-line TKI therapy. Apart from CHR, the first-line therapy produced better results than the seond-line therapy (P < 0.05). CONCLUSION: CML patients in chronic phase and first-line use of TKI have better outcomes.

[Efficacy of tyrosine kinase inhibitor in treatment of chronic myeloid leukemia patients].

OBJECTIVE: To evaluate the effects of tyrosine kinase inhibitors (TKI) in the treatment of chronic myeloid leukemia. METHODS: There were total 655 cases of chronic myeloid leukemia treated in one single-institution enrolled in this study. The dosage of TKI Imatinib was 400 mg/d for chronic phase, 600 mg/d for accelerated and blast phase respectively. Complete blood count, cytogenetic and molecular studies were regularly monitored during the course of therapy. The therapeutic effect was evaluated and the survival analysis was performed. RESULTS: The total complete hematologic response (CHR), major cytogenetic response (MCyR), complete cytogenetic response (CCyR) and major molecular response (MMR) rates were 92.1%, 75.8%, 73.1% and 47.9% respectively. 1-year, 3-year, 5-year and 10-year overall survival (OS) rates were (96.3 +/- 0.8)%, (86.3 +/-1.8)%, (79.0 +/- 2.4)% and (66.5 +/- 4.8)% respectively. 1 year, 3-year, 5-year and 10-year event-free survival (EFS) rates were (92.2 +/- 1.1)%, (77.9 +/- 2.1)%, (67.9 +/- 6.8)% and (35.8 +/- 6.0)% respectively. The proportion of the patients in chronic phase achieving CHR, MCyR, CCyR and MMR were 98.7%, 82.5%, 79.4% and 52.4% respectivly. Compared with chronic phase patients, the efficacy of IM in the treatment of accelerated phase and blast phase patients was significantly lower. The effect of TKI in early chronic phase was better than that in late chronic phase. Early molecular response was associated with a better 5-year EFS, but not OS. CONCLUSION: CML patients in chronic phase treated with TKI have a better outcome. The earlier TKI be used, the better the prognosis and efficacy be achieved.

[A paired case-control study for assessing the relationship between the incidence of malignant lymphomas and the viruses infections].

OBJECTIVE: To evaluate the relationships between the viruses infections and the incidence of malignant lymphomas (ML) in Sichuan province. METHODS: A hospital-based paired case-control study was designed with two controls per case. The case group comprised 97 cases diagnosed as ML by pathological examination; the control group A consisted of 194 subjects randomly selected from those with non-malignancies by matching on both gender and age in the corresponding period. Additionally, a control group B for Epstein-Barr virus(EBV), including 80 subjects, were chosen from other non-malignant diseases at the same time. Enzyme-linked immunosorbent assay(ELISA) was employed to test the serum antibodies and antigens of hepatitis C virus (HCV), human immunodeficiency virus (HIV), cytomegalovirus (CMV), and hepatitis B virus (HBV). The EBV was confirmed by the EBER in situ-hybridization (EBER-ISH) of pathological tissue. RESULTS: The positive rate of EBV in ML group was 70.1%(68/97) and that of control group was 7.5%(6/80). The difference between these two groups showed a statistical significance by conditional logistic regression analysis (OR = 6.58, 95% CI: 16.164-82.846, P = 0.0001). The differences in HCV, CMV and HBV infections between case group and control group demonstrated no statistical significance with P-values of 0.260, 0.258 and 0.399 respectively. We found no positive results of HIV antibody in case group and control group. CONCLUSION: The incidence of ML in Sichuan displayed a significant association with EBV infection. However, there were no relationships between the incidence of ML and the HCV, HBV, HIV, CMV infections in the area.

[A case-control study for assessing the relation between the incidence of malignant lymphomas and environmental factors in Sichuan province].

OBJECTIVE: To evaluate the relationships of malignant lymphoma (ML) and exposure factors, including environmental, drug using, socioeconomic level and life style etc. METHODS: (1) Hospital-based case-control study with 1:2 matching was used; (2) 150 cases of ML and 300 controls were resulted; (3) logistic regression was used. RESULTS: (1) Adjust odds ratios (aOR) regarding contact to organic solvents were: benzene aOR = 2.78, P = 0.001;banana oil aOR = 2.28, P = 0.043; paint aOR = 1.96, P = 0.023; (2) aOR on pesticides contact: organic phosphorus aOR = 1.98, P = 0.034; chrysanthester aOR = 2.57, P = 0.013; organic nitride aOR = 2.55, P = 0.003; (3) aOR of using aspirin was 2.36, P = 0.005; (4) dog-raising: aOR = 1.76, P = 0.034; (5) the aORs of interval-term exposure to small dosage X-ray was 0.49, P = 0.015, and frequently catching cold was 0.67, P = 0.024; (6) the P-value of different occupations was more than 0.05; cigarette smoking OR = 1.01, P = 0.897; giving up smoking OR = 1.17, P = 0.073; alcohol-drinking aOR = 1.01, P = 0.414; hair-dyes OR = 1.06, P = 0.850; hair-perms OR = 1.26, P = 0.438; socioeconomic level OR = 1.00, P = 1.000 and with introversive character OR = 1.26, P = 0.266. CONCLUSIONS: (1) Factors that might increase the risk of suffering from malignant lymphomas would include direct contact to organic solvents and some pesticides (organic phosphorus, chrysanthester and organic nitride), intake of aspirin, as well as dog-raising. (2) Regular exposure to small dosage X-ray and frequently catching cold seemed to decrease the risk of suffering from ML. (3) Occupation, smoking, giving up smoking, alcohol-drinking, hair-dyes, hair-perms, socioeconomic level and introversive character showed no significant relations to the risk of suffering from ML in this study.