尼洛替尼、伊马替尼治疗慢性髓细胞白血病疗效的Meta分析

发布时间：2017-12-28 20:43

本文关键词：尼洛替尼、伊马替尼治疗慢性髓细胞白血病疗效的Meta分析　出处：《昆明医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：[目的]系统评价尼洛替尼(Nilotinib) 300/400mg twice daily与伊马替尼(Imatinib)400mg once daily治疗六个月内新诊断的费城染色体阳性的慢性期的慢性髓细胞白血病(Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP)的疗效,及尼洛替尼(Nilotinib) 300mg twice daily与尼洛替尼(Nilotinib) 400mg twice daily治疗六个月内新诊断的费城染色体阳性的慢性期的慢性髓细胞白血病(Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP)的疗效。[方法]计算机检索The Cochrane Library(2014年第9期)、MEDLINE、PubMed、 EMbase、Ovid, CBM、CNKI、VIP和WanFang Data,同时手工检索相关期刊,收集尼洛替尼与伊马替尼治疗六个月内新诊断的费城染色体阳性的慢性期的慢性髓细胞白血病(Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP)的RCT。所检索文章时限自建库至2014年11月1日。对符合纳入标准的RCT,由两位研究者独立评价纳入文献质量,而后交叉核对,采用RevMan 5.2软件进行Meta分析,采用StataSE12.0软件进行敏感性分析。[结果]纳入的4篇文献中,共有2617例患者。Meta分析结果显示,尼洛替尼300mg twice daily vs伊马替尼400mg, once daily长期治疗Ph+CML-CP时,两者主要分子学反应(Major Molecular Response, MMR), [RR=1.76,95% Cl(1.54,2.01),P=0.22]、完全分子学反应(complete molecular response with a 4 log reduction or greater, CMR4) [RR=2.02,95%Cl(1.68,2.41), P=0.51]差异有统计学意义；尼洛替尼400mg twice daily vs伊马替尼400mg, once daily长期治疗Ph+CML-CP时,两者主要分子学反应(Major Molecular Response, MMR), [RR=1.68,95% Cl(1.47,1.92), P=0.18]、完全分子学反应(complete molecular response with a 4 log reduction or greater, CMR4) [RR=1.75,95% Cl(1.45,2.10), P=0.34]差异有统计学意义；尼洛替尼300mg twice daily vs尼洛替尼400mg twice daily长期治疗Ph+CML-CP时,主要分子学反应(Major Molecular Response, MMR)[RR=0.89, 95%Cl(0.86,1.05), P=0.90]、完全分子学反应(complete molecular response with a4 log reduction or greater, CMR4) [RR=0.87,95% Cl(0.76,1.00), P= 1.00],差异无统计学意义。[结论]对六个月内新诊断的费城染色体阳性的CP-CML疗效评价中,尼洛替尼300/400mg twice daily优于伊马替尼400mg once daily,尼洛替尼300mg twicedaily与尼洛替尼400mg twice daily无差别。
[Abstract]:[Objective] the evaluation system of nilotinib (Nilotinib) 300/400mg twice daily with imatinib (Imatinib) 400mg once daily within six months of treatment of newly diagnosed Philadelphia chromosome positive chronic phase chronic myeloid leukemia (Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP) and the efficacy of nilotinib (Nilotinib 300mg twice daily) and nilotinib (Nilotinib) 400mg twice daily within six months of treatment of newly diagnosed Philadelphia chromosome positive chronic phase chronic myeloid leukemia (Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP) effect. [method] the computer retrieval The Cochrane Library (2014 ninth), MEDLINE, PubMed, EMbase, Ovid, CBM, CNKI, VIP and WanFang Data, while the manual retrieval of relevant journals, collecting nilotinib and imatinib therapy within six months of newly diagnosed Philadelphia chromosome positive chronic phase chronic myeloid leukemia (Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, Ph+CML-CP RCT). The time limit for the retrieved articles is from the establishment of the library to November 1, 2014. According to the inclusion criteria of RCT, two researchers independently evaluated the quality of the included literature. Then the cross check was performed. RevMan 5.2 software was used for Meta analysis, and StataSE12.0 software was used for sensitivity analysis. [results] of the 4 documents included, there were 2617 patients. The results of Meta analysis showed that 300mg twice daily vs nilotinib and imatinib 400mg, once daily Ph+CML-CP for the long-term treatment, two major molecular response (Major Molecular, Response, MMR), [RR=1.76,95% Cl (1.54,2.01), P=0.22] (complete molecular, complete molecular response response with a 4 log reduction or greater CMR4 [RR=2.02,95%Cl (1.68,2.41)), there were significant differences in P=0.51]; 400mg twice daily vs nilotinib and imatinib 400mg, once daily Ph+CML-CP for the long-term treatment, two major molecular response (Major Molecular, Response, MMR), [RR=1.68,95% Cl (1.47,1.92), P=0.18], complete molecular response complete molecular response (with a 4 log reduction or greater, CMR4 [RR=1.75,95% Cl) (1.45,2.10), there were significant differences in P=0.34]; 300mg twice daily vs nilotinib nilotinib 400mg twic E daily for long-term treatment of Ph+CML-CP, a major molecular response (Major Molecular, Response, MMR) [RR=0.89, 95%Cl (0.86,1.05), P=0.90] (complete molecular, complete molecular response response with A4 log reduction or greater, CMR4) [RR=0.87,95% Cl (0.76,1.00), P= 1.00], the difference was not statistically significant. [Conclusion] the evaluation of six months of newly diagnosed Philadelphia chromosome positive CP-CML effect, 300/400mg twice daily is better than that of nilotinib and imatinib mesylate for 400mg once daily, 300mg twicedaily and nilotinib nilotinib 400mg twice daily no difference.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R733.72

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