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| Clinical Study on Second-generation Tyrosine Kinase Inhibitors in the First-line |and Second-line Treatment of Chronic Myeloid Leukemia |
| CHEN Heng, JIANG Yuanqiang, SHEN Yunfeng, et al |
| The People's Hospital of Wuxi, Jiangsu Wuxi 214000, China |
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Abstract Objective: To investigate the clinical effect of second-generation tyrosine kinase inhibitors in the treatment of chronic myeloid leukemia (CML). Methods: A total of 64 patients with CML treated between January 2013 and December 2016 were selected as study subjects and treated with second-generation tyrosine kinase inhibitor (TKI). Among them, there were 41 cases treated with Nilotinib and 23 cases with Dasatinib. In patients treated by TKI, there were 13 cases receiving first-line medication and 51 cases receiving second-line medication. All were followed up for 6 ~ 54 months, median 18 months. The overall complete hematologic remission (CHR) rate, CCyR rate, rate of major cytogenetic response (MCyR), MMR rate, follow-up overall survival rate (OS) and event free survival rate (EFS) were observed; Meanwhile, the responses of first-line and second-line treatment and adverse drug reactions were compared. Results: At the end of follow-up, 43 cases continued second-generation TKI treatment, 14 cases died, 2 cases stopped medication, 2 cases were lost to follow up and 3 cases changed the medication regimen; In terms of overall responses to treatment, the rates of CHR, MCyR, CCyR and MMR were 98.44%, 64.00%, 59.37% and 43.75% respectively; In terms of overall survival status, OS and EFS decreased with duration of the disease. The rates of CCyR, MCyR and MMR of first-line treatment were significantly higher than the second-line treatment (P < 0.05); There were no significant differences in the incidence of adverse drug reactions between Nilotinib and Dasatinib (P > 0.05). Conclusion: The effect of Nilotinib and Dasatinib second-generation TKI in the treatment of CML is clear. The prognosis is good and safety is better; The effect of second generation TKI first-line treatment is better than second-line treatment in treating CML.
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2017, Vol. 23 
