Volume 19 Issue 1
Jan.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(1): 52-54,112
SU Li-fang, WU Fen-zhi, KONG Hong-wei, LYU Hong-jiao, WU Wen-ping, WANG Jia-heng. Diagnosis and treatment of 71 cases of chronic myeloid leukaemia with secondary myelofibrosis[J]. Chinese Journal of General Practice, 2021, 19(1): 52-54,112. doi: 10.16766/j.cnki.issn.1674-4152.001728
Citation: SU Li-fang, WU Fen-zhi, KONG Hong-wei, LYU Hong-jiao, WU Wen-ping, WANG Jia-heng. Diagnosis and treatment of 71 cases of chronic myeloid leukaemia with secondary myelofibrosis[J]. Chinese Journal of General Practice, 2021, 19(1): 52-54,112. doi: 10.16766/j.cnki.issn.1674-4152.001728
shu

Diagnosis and treatment of 71 cases of chronic myeloid leukaemia with secondary myelofibrosis

doi: 10.16766/j.cnki.issn.1674-4152.001728

  • Department of Hematology, Quzhou People's Hospital, Quzhou, Zhejiang 324000, China

Funds:

 2017RC032

 20172037

  • Received Date: 2020-10-19
    Available Online: 2022-02-19
    Abstract
  •   Objective  To analyse the clinical treatment effect and follow-up results of patients with chronic myeloid leukaemia (CML) complicated with myelofibrosis (MF) and to provide relevant data for clinical treatment and prognosis.  Methods  The clinical data of 71 patients with CML complicated with MF admitted in the Department of Hematology of Quzhou People's Hospital from January 2014 to June 2019 were analysed retrospectively. The course of CML was 3-9 years, and all of the patients received systematic treatment in the hospital. In the treatment maintenance or remission period, progressive anaemia, generalised bone pain and megaspleen appeared, which was consistent with the diagnosis of MF (I degree). CML: Glivec (400-600 mg/time, 1 time/day; or 800 mg/time, 2 times/day, 800 mg/time) was used in the treatment for 4 weeks/course×4 courses; CML secondary bone fibrosis: when the baseline PLT was 100-200×109/L, the initial dose of lucotinib was 2 times/day, 15 mg/time; when the baseline PLT was>200×109/L, the initial dose was 2 times/day, 20 mg/time. The treatment effect, follow-up results and survival rate were observed.  Results  Clinical treatment results: after 1 week of treatment, the symptoms of pain and anaemia were improved, and the spleen was less than 8 cm under the rib; after 5 months of treatment, the haematopoietic function of the bone marrow was partially restored, and the morphology of classified cells was generally normal; haemoglobin level was≥100 g/L; white blood cell count was 9-10×109/L, and the spleen was < 7 cm under the rib. The incidence of complications was 15.49% (11/71). The average follow-up time was 12-63 months. Follow-up results: 9 cases were lost (12.68%); 19 cases survived without recurrence (26.76%); 38 cases (53.52%) survived but relapsed and turned into cataclysm. The median time of transformation was 35.8 months. Five cases (7.04%) died of severe infection (two cases of central nervous system infection and three cases of respiratory tract infection).  Conclusion  Targeted drug therapy can achieve a certain short-term effect in the treatment of patients with MF secondary to CML. The long-term effects such as the change of the condition to cataclysm and survival are related to the severity of myelofibrosis. The aggravation of bone marrow fibrosis can promote the change or death of the disease.

     

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