河南省慢性髓性白血病患者伊马替尼治疗依从性观察及其对12个月时细胞遗传学反应的影响

OBJECTIVE: To observe the compliance to Imatinib (IM) 400 mg/d in 513 patients with chronic myeloid leukemia chronic phase (CML-CP) referred to Henan Province Tumor Hospital from March 2013 through March 2015 and its influence on cytogenetic response at 12 months. METHODS: Of 513 patients with CML-CP from Henan province, 456 cases covered by the new rural cooperative medical insurance, and 57 cases by other medical insurances. Patients were told the importance of regular monitoring after receiveing IM treatment, including bone marrow, BCR-ABL fusion genes and chromosomes. All patients were followed up for 12 months, according to the circumstances of the periodic review, to be subjected into good or poor compliance groups. Chi-square test was used to compare CCyR rate at 12 months and Sokal score difference of the distribution of risk between two groups. Diagnosis to IM treatment duration, level of education, personal income, convenience of residence to the hospital's traffic, age and gender were recorded, the Cox single and multiple factors analyses were implied to probe the factors affecting CCyR 12 months. RESULTS: After receving IM 400 mg/d treatment for 12 months, the CCyR rate in good compliance group (82.2%) was significantly higher than in poor compliance one (50.9%) (P<0.001). Sokal scores of risk stratification were 121, 132, 101, respectively in good compliance group; which were as of 58, 61, 40, respectively in poor compliance group, the difference of disease risk between the two groups was not statistical significance (P=0.721). Sokal score, annual income, level of education and diagnosis to treatment duration were positively related with the 12 months CCyR rate by the Cox single factor analysis (P<0.05). Level of education (B=0.457,P=0.018), income (B=0.267,P= 0.035) and treatment compliance (B=0.587,P=0.026) were independent risk factors for the 12 months CCyR rate by the Cox multiple factor analysis. CONCLUSION: Patients in CML-CP with good compliance achieved satisfactory responses when receving IM treatment for 12 months. Low education, low income and poor treatment compliance were independent risk factors for the CCyR rate at 12 months.