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*Imatinibmesylate(formerlySTI571)isaselectivetyrosinekinaseinhibitorthathasbeenshowninbothinvitroandinvivostudiestotargetandinhibittheactivityofafewspecifictyrosinekinases.Havingdemonstratedmeasurableandsignificantantitumoractivityinclinicalstudies,
imatinibmesylateisindicatedforthetreatmentofNewlydiagnosedchronicphasePhiladelphiachromosome–positive(Ph+)CMLinadultsPh+CMLinblasticphase,acceleratedphase,orchronicphasefollowingfailureofIFN-atherapyPh+CMLinpediatricpatientswhoexperiencedrecurrencefollowingstemcelltransplantation(SCT)Ph+CMLthatisresistanttoIFN-atherapyinpediatricpatientsDrukerBJ,TamuraS,BuchdungerE,etal.EffectsofaselectiveinhibitoroftheAbltyrosinekinaseonthegrowthofBcr-Ablpositivecells.NatMed.1996;2:561-566.KantarjianH,SawyersC,HochhausA,etal.Hematologicandcytogeneticresponsestoimatinibmesylate
inchronicmyelogenousleukemia.NEnglJMed.2002;346:645-652.O’BrienSG,GuilhotF,LarsonRA,etal.Imatinibcomparedwithinterferonandlow-dosecytarabinefornewlydiagnosedchronic-phasechronicmyeloidleukemia.NEnglJMed.2003;348:994-1004.SawyersCL,HochhausA,FeldmanE,etal.Imatinibinduceshematologicandcytogeneticresponsesinpatientswithchronicmyelogenousleukemiainmyeloidblastcrisis:resultsofaphaseIIstudy.Blood.2002;99:3530-3539.TalpazM,SilverRT,DrukerBJ,etal.Imatinibinducesdurablehematologicandcytogeneticresponsesinpatientswithacceleratedphasechronicmyeloidleukemia:resultsofaphase2study.Blood.2002;99:1928-1937.***图中显示,随着格列卫治疗时间的延长,无论是CHR,还是MCR,CCR,累计最佳疗效持续性升高,以CCR组为例,12个月时累积的CCR最佳疗效为69%,第五年时升至87%,换言之,即使在12个月时未获得CCR,继续格列卫治疗仍然有机会获得CCR.CumulativeratesofCHRandCCyRwereestimatedaccordingtotheKaplan-Meiermethod,inwhichpatientswhocrossedovertotheothertreatmentarmordiscontinuedtreatmentforreasonsotherthanprogression
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