Chronic myelogenous leukemia.
Chronic myelogenous leukemia.
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DOI：
10.1188/05.cjon.535-538
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发表时间：
2005-10-01
影响因子：
1.1
通讯作者：
D'Antonio, Jocelyn
中科院分区：
文献类型：
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作者：
D'Antonio, Jocelyn
慢性粒细胞白血病（CML）占所有白血病的约14%，并且以约1/100，000的频率发生。这在儿童中是罕见的。症状包括疲劳、体重减轻、出汗和脾脏肿大引起的腹部不适。白色血细胞计数范围可为100-600 μ l。CML有三个阶段：慢性期、加速期和急变期。大多数患者在慢性期被诊断出来。电离辐射与某些CML病例有关，但在大多数个体中，原因尚不清楚。费城染色体是一种获得性遗传突变，以22号染色体和9号染色体易位为代表，驱动CML的白血病变化。甲磺酸伊马替尼是一种酪氨酸激酶抑制剂，于2002年被批准用于治疗CML的所有阶段。由于其有效性，伊马替尼已成为大多数CML患者的治疗选择。干细胞移植也是符合条件的患者的一种选择。这是唯一的治疗慢性粒细胞白血病。针对无法耐受伊马替尼或对伊马替尼产生耐药性的患者正在研究的两种药物是BMS-354825和AMN 107。了解CML新疗法的肿瘤科护士可以成为患者的有效资源。
Chronic myelogenous leukemia (CML) represents about 14% of all leukemias and occurs with a frequency of about 1 in 100,000. It is rare in children. Symptoms include fatigue, weight loss, sweating, and abdominal discomfort from an enlarged spleen. The white blood cell count can range from 100-600 ul. CML has three phases: the chronic phase, accelerated phase, and blast phase. Most patients are diagnosed during the chronic phase. Ionizing radiation has been implicated in some cases of CML, but in most individuals no cause is known. The Philadelphia chromosome, an acquired genetic mutation represented by a translocation of chromosome 22 and chromosome 9, drives the leukemic changes in CML. Imatinib mesylate, a tyrosine kinase inhibitor, was approved in 2002 for the treatment of all phases of CML. Because of its effectiveness, imatinib has become the treatment of choice for most patients with CML. Stem cell transplantation also is an option for eligible patients. It is the only curative treatment for CML. Two drugs under study for patients who cannot tolerate or who become resistant to imatinib are BMS-354825 and AMN107. Oncology nurses who are knowledgeable about new therapies for CML can be effective resources for their patients.