Abstract

目的总结51例华氏巨球蛋白血症(WM)患者的临床特征及预后,重点评估伊布替尼治疗WM的疗效和不良反应,为WM诊疗提供经验和借鉴。方法回顾性分析2008年11月至2019年10月海军军医大学附属长征医院收治的51例初诊WM患者的基线临床特征、疗效及预后。结果51例患者男女比例为2.64∶1,中位年龄65(46~84)岁。ISSWM危险分层:低危组9例(18%)、中危组21例(41%)、高危组21例(41%),27例(73%)存在MYD88L265P突变。中位随访时间38.6(0.3~120.0)个月,中位无进展生存时间为46.4个月,中位总生存时间未达到。接受伊布替尼治疗的16例患者总体缓解率为87%,主要缓解率为80%,起效速度快,达到至少部分缓解的中位时间为8周,与其他药物组相比差异有统计学意义(P<0.05)。结论WM多见于老年男性,多数患者合并MYD88L265P突变。伊布替尼治疗WM疗效确切,即使是高龄、ISSWM高危患者,也有较高的总体缓解率、主要缓解率。伊布替尼起效速度较快,严重不良反应少见,是一种安全、有效的治疗方案。

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