氟马替尼二线治疗老年慢性髓性白血病的疗效及影响因素分析

doi:10.3969/j.issn.1003-9198.2025.01.016

实用老年医学 ›› 2025, Vol. 39 ›› Issue (1): 70-73.doi: 10.3969/j.issn.1003-9198.2025.01.016

氟马替尼二线治疗老年慢性髓性白血病的疗效及影响因素分析

张司琪, 孙晓星, 杨世礼, 葛洪峰, 丰江舟

236800 安徽省亳州市,安徽医科大学附属亳州医院血液内科

收稿日期:2024-01-18 出版日期:2025-01-20 发布日期:2025-01-15
通讯作者: 丰江舟,Email:feng421937821@163.com
基金资助:
亳州市重点研发计划项目(bzzc2023061)

Analysis of the efficacy and factors affecting the second-line treatment of chronic myeloid leukemia in the elderly receiving flumatinib

ZHANG Siqi, SUN Xiaoxing, YANG Shili, GE Hongfeng, FENG Jiangzhou

Department of Hematology, the Affiliated Bozhou Hospital of Anhui Medical University, Bozhou 236800, China

Received:2024-01-18 Online:2025-01-20 Published:2025-01-15
Contact: FENG Jiangzhou, Email: feng421937821@163.com

摘要/Abstract

摘要： 目的分析氟马替尼二线治疗老年慢性髓性白血病(CML-CP)的疗效及影响因素。方法回顾性分析2020—2023年在我院接受氟马替尼作为二线药物治疗3个月以上的25例老年CML-CP病人的病例资料,评估氟马替尼治疗后的疗效、影响因素和安全性。结果 25例病人中位随访24(2~48)个月,22例(88.0%)获得完全血液学缓解(CHR),10例(40.0%)获得主要分子学反应(MMR),中位PFS和OS分别为19.4个月和22.5个月。单因素分析结果显示,Sokal积分为影响病人MMR的因素,Sokal积分、伊马替尼治疗时间和治疗前耐药状态是获得完全细胞遗传学反应(CCyR)的影响因素。血液学不良反应发生率为28.0%(7/25),非血液学不良反应发生率为20.0%(5/25)。结论氟马替尼二线治疗老年CML-CP安全有效。

关键词: 慢性髓性白血病, 老年人, 氟马替尼, 疗效

Abstract: Objective To analyze the efficacy and influencing factors of flumatinib as second-line treatment for elderly patients with chronic myeloid leukemia in chronic phase(CML-CP). Methods A retrospective study including 25 elderly CML-CP patients who received flumatinib as a second-line drug for more than 3 months in our hospital from 2020 to 2023 was conducted, and the efficacy and influencing factors were analyzed. Results A total of 25 patients who failed first-line imatinib treatment were collected, with a median follow-up of 24 (2-48) months, 22 (88.0%) patients obtained complete hematological response(CHR)and 10 (40.0%) patients obtained major molecular response(MMR). Univariate analysis showed that Sokal score was a factor influencing patients to obtain MMR; Sokal score, duration of imatinib treatment and pretreatment resistance status were influencing factors of CCyR. The median progression-free survival(PFS)and overall survival(OS)were 19.4 months and 22.5 months, respectively. The incidence rate of hematologic adverse events was 28.0% (7/25) and the incidence rate of non-hematologic adverse events was 20.0% (5/25). Conclusions Flumatinib is safe and effective in the second-line treatment of CML-CP in the elderly.

Key words: chronic myeloid leukemia, aged, flumatinib, efficacy

中图分类号:

R 557

张司琪, 孙晓星, 杨世礼, 葛洪峰, 丰江舟. 氟马替尼二线治疗老年慢性髓性白血病的疗效及影响因素分析[J]. 实用老年医学, 2025, 39(1): 70-73.

ZHANG Siqi, SUN Xiaoxing, YANG Shili, GE Hongfeng, FENG Jiangzhou. Analysis of the efficacy and factors affecting the second-line treatment of chronic myeloid leukemia in the elderly receiving flumatinib[J]. Practical Geriatrics, 2025, 39(1): 70-73.

参考文献

[1] ÓBRIEN S, BERMAN E, BORGHAEI H, et al. NCCN clinical practice guidelines in oncology: chronic myelogenous leukemia[J]. J Natl Compr Canc Netw, 2009, 7(9):984-1023.
[2] HOCHHAUS A, LARSON R A, GUILHOT F, et al. Long-term outcomes of imatinib treatment for chronic myeloid leukemia[J]. N Engl J Med, 2017, 376(10):917-927.
[3] MULLER M C. New drug for chronic myeloid leukemia might stimulate the market[J]. Clin Cancer Res, 2021, 27 (1): 3-4.
[4] ZHANG L, MENG L, LIU B, et al. Flumatinib versus Imatinib for newly diagnosed chronic phase chronic myeloid leukemia: a phase III, randomized, open-label, multi-center FESTnd study[J]. Clin Cancer Res, 2021, 27(1):70-77.
[5] 中华医学会血液学分会. 慢性髓性白血病中国诊断与治疗指南(2020年版)[J]. 中华血液学杂志, 2020, 41(5):353-364.
[6] FAIRCHILD A T, TANKSLEY J P, TENENBAUM J D, et al. Interrater reliability in toxicity identification: limitations of current standards[J]. Int J Radiat Oncol Biol Phys, 2020, 107(5):996-1000.
[7] SHAH N P, ROUSSELOT P, SCHIFFER C, et al. Dasatinib in imatinib-resistant or-intolerant chronic-phase, chronic myeloid leukemia patients: 7-year follow-up of study CA180-034[J]. Am J Hematol, 2016, 91(9):869-874.
[8] KANTARJIAN H M, HUGHES T P, LARSON R A, et al. Long-term outcomes with frontline nilotinib versus imatinib in newly diagnosed chronic myeloid leukemia in chronic phase: ENESTnd 10-year analysis[J]. Leukemia, 2021, 35 (2): 440-453.
[9] HEHLMANN R, LAUSEKER M, SAUßELE S, et al. Assessment of imatinib as first-line treatment of chronic myeloid leukemia: 10-year survival results of the randomized CML study Ⅳ and impact of non-CML determinants[J]. Leukemia, 2017, 31 (11): 2398-2406.
[10] KALMANTI L, SAUSSELE S, LAUSEKER M, et al. Safety and efficacy of imatinib in CML over a period of 10 years: data from the randomized CML-study Ⅳ[J]. Leukemia, 2015, 29 (5): 1123-1132.
[11] YANG M, XI Q, JIA W, et al. Structure-based analysis and biological characterization of imatinib derivatives reveal insights towards the inhibition of wild-type BCR-ABL and its mutants[J]. Bioorg Med Chem Lett, 2019, 29 (24): 126758.
[12] GAO H, LI L, MU J, et al. Efficacy of Flumatinib in CML patients with F359V/C mutation[J].Indian J Hematol Blood Transfus, 2023, 39(2):344-346.
[13] LI Z, MENG L, ZHANG Y, et al. Frontline flumatinib versus imatinib in patients with chronic myeloid leukemia in chronic phase: results from the China randomized phase Ⅲ study[J]. J Clin Oncol, 2019, 37 (15_suppl): 7004.
[14] 张小帅, 刘兵城, 杜新, 等. 氟马替尼与伊马替尼治疗初发慢性髓性白血病慢性期患者的有效性及严重血液学不良反应发生率比较[J]. 中华血液学杂志, 2023, 44(9):728-736.
[15] LUO H, QUAN H, XIE C, et al. HH-GV-678, a novel selective inhibitor of Bcr-Abl, outperforms imatinib and effectively overrides imatinib resistance[J]. Leukemia, 2010, 24 (10): 1807-1809.
[16] HUANG J, XIAO J, HE L, et al. Overcoming flumatinib resistance in chronic myeloid leukaemia: insights into cellular mechanisms and ivermectin’s therapeutic potential[J]. J Cell Mol Med, 2024, 28(14): e18539.

氟马替尼二线治疗老年慢性髓性白血病的疗效及影响因素分析

Analysis of the efficacy and factors affecting the second-line treatment of chronic myeloid leukemia in the elderly receiving flumatinib

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

推荐阅读 0

[1]	王雪, 张振勇, 许彬, 朱娅, 周璇, 张永嘉, 庄瑞娟. 老年血管性痴呆病人血清VEGF、BDNF水平与病情严重程度的关系及对预后的预测价值[J]. 实用老年医学, 2025, 39(1): 32-36.
[2]	刘川, 潘一鸣, 于文华, 张婉淑, 李嘉潼, 李夏夏, 邢怡文, 李静, 马丽娜. 临床生理弹性评估量表在老年住院病人中的信效度检验[J]. 实用老年医学, 2025, 39(1): 37-40.
[3]	周晶, 孙洛阳, 王玲, 马加旭. 竖脊肌平面阻滞联合星状神经节阻滞在老年腹腔镜全子宫切除术中的应用效果[J]. 实用老年医学, 2025, 39(1): 51-55.
[4]	王美娟, 姜学忠, 王会, 刘小静, 庞慧燕. 二维斑点追踪技术评估颈动脉结构正常的超重老年人群动脉功能的应用价值[J]. 实用老年医学, 2025, 39(1): 56-60.
[5]	尹鹏程, 王鑫智, 张林忠. 老年病人记忆能力相关的脑电非线性分析研究[J]. 实用老年医学, 2025, 39(1): 61-65.
[6]	李婷, 裴军芳, 孙珊珊. 老年肺部感染病人致病菌耐药情况及耐药程度对血清IL-6、IL-10、CRP水平的影响[J]. 实用老年医学, 2025, 39(1): 83-87.
[7]	邬王怡, 赵春艳, 孙玉肖. 不同膳食结构对老年高血压病人早餐后低血压的影响[J]. 实用老年医学, 2025, 39(1): 88-92.
[8]	宋承雅, 杨颖, 洪侃. 短链脂肪酸对老年2型糖尿病合并肌少症的影响及其机制[J]. 实用老年医学, 2025, 39(1): 98-101.
[9]	丛晓飞, 李铭麟, 石春来. 老年口腔衰弱与多重用药的关系及干预策略[J]. 实用老年医学, 2024, 38(9): 872-875.
[10]	李毛毛, 张飞, 沈鑫, 李洁华. 老年人口腔衰弱与跌倒关系的研究进展[J]. 实用老年医学, 2024, 38(9): 876-879.
[11]	张飞, 李毛毛, 李铭麟, 王佳贺. 老年人口腔衰弱与抑郁症的相关性研究进展[J]. 实用老年医学, 2024, 38(9): 884-888.
[12]	李江, 邱雁, 王婷, 王丹, 虞一帆, 濮玲丽, 卜玲. 老年肺腺癌病人术前全身免疫炎症指数/血清白蛋白与临床病理特征的相关性研究[J]. 实用老年医学, 2024, 38(9): 893-896.
[13]	戴静, 崔焱. 糖化血红蛋白变异性与老年2型糖尿病病人认知功能障碍的相关性分析[J]. 实用老年医学, 2024, 38(9): 931-935.
[14]	张星星, 张海洋, 何小菁, 鲁翔. 不同肥胖指标与老年人糖尿病患病风险的调查研究[J]. 实用老年医学, 2024, 38(9): 940-943.
[15]	倪红艳, 陈云, 张其兵, 马一鸣, 解成兰. 电针对老年病人下肢骨科手术围术期认知功能及炎症因子的影响[J]. 实用老年医学, 2024, 38(9): 944-947.