Page 94 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第5期
·690 · Journal of Nanjing Medical University（Natural Sciences） 2022年5月

·临床研究·

RDW 对初诊慢性粒细胞白血病慢性期患者 TKI 治疗反应的早

期预测价值

胡金花，徐子瑶，孙 倩，刘文洁，洪 鸣，钱思轩 *

南京医科大学第一附属医院血液科，江苏 南京 210029

［摘 要］ 目的：探讨初诊慢性粒细胞白血病（chronic myeloid leukemia，CML）患者红细胞分布宽度（red blood cell distribution
width，RDW）与酪氨酸激酶抑制剂（tyrosine kinase inhibitor，TKI）早期治疗反应（治疗后3、6、12个月）的关系。方法：回顾性分
析175例2010年10月—2021年8月在南京医科大学第一附属医院接受治疗的初诊CML慢性期（CML⁃CP）患者，均接受一代或
二代TKI（伊马替尼或尼洛替尼、达沙替尼、氟马替尼）治疗，依据治疗反应分为最佳反应、警告和治疗失败组，结合初诊时RDW
及相关临床资料对预后影响的分析。利用受试者工作特征曲线（receiver operating characteristic，ROC）优化临床指标的cut⁃off
值。结果：初诊时RDW≥16.15%的患者3个月和6个月治疗反应（警告和失败）明显多于RDW低者（P＜0.05）。分析TKI治疗3个
月疗效为警告且未早期换药患者，结合初诊时的 RDW，发现高 RDW 组在 6 个月或 12 个月时治疗失败率明显高于低 RDW 组
（P＜0.05）。结论：CML⁃CP患者RDW为TKI早期治疗反应（3和6个月）的独立预测指标；3个月为警告患者且RDW高者在6个
月和12个月更易发生治疗失败。
［关键词］ 慢性粒细胞白血病；红细胞分布宽度；TKI；治疗反应
［中图分类号］ R733.7 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）05⁃690⁃06
doi：10.7655/NYDXBNS20220514

Early predictive value of RDW in response to TKI in newly diagnosed chronic phase
chronic myeloid leukemia patients
HU Jinhua，XU Ziyao，SUN Qian，LIU Wenjie，HONG Ming，QIAN Sixuan *
Department of Hematology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：This study aims to investigate the association of red blood cell distribution width（RDW）to the treatment
response in the newly diagnosed patients with chronic myeloid leukemia（CML）after 3 months，6months and 12 months of tyrosine
kinase inhibitor（TKI）treatment. Methods：A retrospective analysis of 175 newly diagnosed CML chronic phase patients who were
treated in the First Affiliated Hospital of Nanjing Medical University from October 2010 to August 2021，all patients were treated with
first⁃generation TKI（imatinib）or secend⁃generation TKI（nilotinib，dasatinib and flumatinib）. According to the treatment response，
they were divided into two groups：the optimal response group and the warning or treatment failure group，to analyze the influence of
RDW and related clinical data on treatment response. The receiver operating characteristic（ROC）curve was used to optimize the cut⁃
off values of clinical indicator. Results：Patients with RDW ≥ 16.15% at first diagnosed had significantly worse response（warnings
and failures）to treatment at 3 and 6 months than those with lower RDW（P＜0.05）. Analyzing the patients who did not achieve the best
response after 3 months of TKI treatment and did not change the treatment early，combined with the RDW at the first diagnosed，it was
found that the treatment failure rate of the high RDW group at 6 or 12 months was significantly higher than that of the low RDW group
（P＜0.05）. Conclusion：RDW at the first diagnosis of CML⁃CP patients is an independent predictor for early treatment response（3
and 6 months）of TKI. Patients with high RDW and warning for the 3⁃month efficacy evaluation are more likely to fail treatment at 6
and 12 months
［Key words］ chronic myeloid leukemia；red blood cell distribution width；TKI；treatment response
［J Nanjing Med Univ，2022，42（05）：690⁃695］
［基金项目］ 国家自然科学基金（81870119，82170153）
∗
通信作者（Corresponding author），E⁃mail：qiansx@medmail.com.cn