目的 探討格列衛(wèi)在1例慢性粒細(xì)胞性白血病慢性期的患者的最佳應(yīng)用方案.
方法 計(jì)算機(jī)檢索ACP Journal Club (1991～2005年4月)、Cochrane圖書(shū)館(2005年第2期)和MEDLINE(1990～2005年4月),收集格列衛(wèi)治療慢性粒細(xì)胞白血病慢性期的系統(tǒng)評(píng)價(jià)、臨床隨機(jī)對(duì)照試驗(yàn)、衛(wèi)生經(jīng)濟(jì)學(xué)評(píng)價(jià)等,并對(duì)所獲證據(jù)質(zhì)量進(jìn)行評(píng)價(jià).
結(jié)果 高質(zhì)量的臨床證據(jù)表明:在血液學(xué)和細(xì)胞遺傳學(xué)緩解率以及生存質(zhì)量方面,格列衛(wèi)均優(yōu)于傳統(tǒng)療法,且副作用相對(duì)較少.結(jié)合我們的臨床經(jīng)驗(yàn),并考慮患者及其家屬的意愿,最后為患者制定治療方案為格列衛(wèi)400 mg qd,隨訪3個(gè)月血液指標(biāo)學(xué)完全緩解,ph染色體1/30(+),達(dá)到主要細(xì)胞遺傳學(xué)緩解,且無(wú)明顯不良反應(yīng)發(fā)生.
結(jié)論 格列衛(wèi)是治療慢性粒細(xì)胞性白血病慢性期的有效藥物,可作為臨床一線用藥.但其長(zhǎng)期療效和不良反應(yīng)以及經(jīng)濟(jì)學(xué)評(píng)價(jià)仍有待進(jìn)一步研究.
引用本文： 代 陽(yáng),吳紅梅,李 峻. 格列衛(wèi)在1例慢性粒細(xì)胞白血病慢性期患者中的循證應(yīng)用. 中國(guó)循證醫(yī)學(xué)雜志, 2005, 05(11): 879-881. doi: 復(fù)制
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- 6. Marin D, Marktel S, Szydlo R, Klein JP, Bua M, Foot N, Olavarria E, Shepherd P, Kanfer E, Goldman JM, Apperley JF. Survival of patients with chronic-phase chronic myeloid leukaemia on imatinib after failure on interferon alfa[J]. Lancet, 2003; 362(9384): 617-619.
- 7. O’Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, Cornelissen JJ, Fischer T, Hochhaus A, Hughes T, Lechner K, Nielsen JL, Rousselot P, Reiffers J, Saglio G, Shepherd J, Simonsson B, Gratwohl A, Goldman JM, Kantarjian H, Taylor K, Verhoef G, Bolton AE, Capdeville R, Druker BJ; IRIS Investigators. Imatinib Compared with Interferon and Low-Dose Cytarabine for Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia[J]. N Engl J Med, 2003; 348(11): 994-1004.