Analysis of the efficacy and influencing factors of nilotinib or dasatinib as second- or third-line treatment in patients with chronic myeloid leukemia in the chronic phase and accelerated phase
10.3760/cma.j.issn.0253-2727.2020.02.002
- VernacularTitle: 尼洛替尼和达沙替尼作为二三线药物治疗慢性髓性白血病慢性期和加速期患者的疗效及影响因素分析
- Author:
Ting YUAN
1
;
Yueyun LAI
;
Yazhen QIN
;
Hongxia SHI
;
Xiaojun HUANG
;
Yue HOU
;
Qian JIANG
Author Information
1. Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China
- Publication Type:Journal Article
- Keywords:
Leukemia, myeloid, chronic, BCR-ABL positive;
Nilotinib;
Dasatinib;
Imatinib
- From:
Chinese Journal of Hematology
2020;41(2):93-99
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and prognosis of nilotinib or dasatinib as second- or third-line treatment in patients with chronic myeloid leukemia (CML) in the chronic phase (CP) and accelerated phase (AP) .
Methods:From January 2008 to November 2018, the data of CML patients who failed first- or second-line tyrosine kinase inhibitor (TKI) -therapy received nilotinib or dasatinib as second-line and third-line therapy were retrospectively reviewed.
Results:A total of 226 patients receiving nilotinib or dastinib as second-line (n=183) and third-line (n=43) therapy were included in this study. With a median follow-up of 21 (range, 1-135) months, the cumulative rates of complete hematological response (CHR) , complete cytogenetic response (CCyR) and major molecular response (MMR) were 80.4%, 56.3%and 38.3%, respectively in those receiving TKI as second-line TKI therapy. The 3-year progression-free survival (PFS) and overall survival (OS) rates were 78.7%and 93.1%, respectively. Multivariate analyses showed that Sokal high risk, female gender, the best response achieved
Conclusions:The efficacy of dasatinib and nilotinib as second- or third-line TKI-therapy were active in the CML patients with TKI-resistance. The best response achieved on previous TKI-therapy, the disease phase before switching TKI, and the severe hematologic toxicity developing on the current TKI-therapy were associated with the responses and outcomes.
