摘要目的:探讨化疗联合索拉非尼方案对Fms样酪氨酸激酶3基因内部串联重复序列（FLT3-ITD）阳性急性髓系白血病（AML）患者预后的影响，从而寻找更有效的治疗方案。方法:回顾性分析齐齐哈尔医学院附属第二医院2015年1月至2017年1月收治的初治AML患者60例的临床资料，按FLT3-ITD阳性与否及治疗方法分为三组，观察组（FLT3-ITD阳性， n=19）在常规化疗基础上联合索拉非尼治疗，对照组1（FLT3-ITD阳性， n=21）在化疗基础上未联合索拉非尼治疗，对照组2（FLT3-ITD阴性， n=20）常规化疗。比较三组第1个疗程、第4个疗程治疗后的效果。 结果:第1个疗程后，对照组2完全缓解率为50.0%（10/20），高于观察组［15.8%（3/19）］和对照组1［4.8%（1/21）］，差异有统计学意义（ H=13.39， P < 0.05）；第4个疗程后，观察组、对照组2、对照组1完全缓解率分别为63.2%（12/19）、60.0%（12/20）、4.8%（1/21），差异有统计学意义（ H=19.21， P < 0.05）。随访4年，观察组、对照组1、对照组2中位生存期分别为36.63、24.15、45.00个月，无事件生存期分别为18.00、9.82、24.90个月，对照组2中位生存期、无事件生存期均长于观察组、对照组1（χ 2=19.93、23.04，均 P < 0.001）。 结论:采用化疗联合索拉非尼方案治疗初治FLT3-ITD阳性AML，患者可综合获益并获得生存优势。

abstractsObjective:To investigate the effect of chemotherapy combined with sorafenib on the prognosis of FLT3 internal tandem duplication (FLT3-ITD)-positive acute myeloid leukemia and to find a more effective treatment.Methods:The clinical data of 60 patients who were newly diagnosed with acute myeloid leukemia and who received treatment in The Second Affiliated Hospital of Qiqihar Medical University from January 2015 to January 2017 were retrospectively analyzed. The patients were divided into three groups according to whether they were positive for FLT3-ITD and the treatment method they used. The observation group (FLT3-ITD-positive, n = 19) were treated with sorafenib based on routine chemotherapy. The control group 1 (FLT3-ITD-positive, n = 21) was treated only with routine chemotherapy. The control group 2 (FLT3-ITD-negative, n = 20) was treated only with routine chemotherapy. After the first and fourth courses of treatment, clinical efficacy was compared among the three groups. Results:After the first course of treatment, the complete remission rate in control group 2 was 50.0% (10/20), which was significantly higher than 15.8% (3/19) in the observation group and 4.8% (1/21) in the control group 1 ( H = 13.39, P < 0.05). After the fourth course of treatment, the complete remission rate in the observation group, control group 2, and control group 1 was 63.2% (12/19), 60.0% (12/20), and 4.8% (1/21), respectively, and the differences were statistically significant ( H = 19.21, P < 0.05). Four-year follow-up results showed that the median survival time in the observation group, control group 1, and control group 2 was 36.63, 24.15, and 45.00 months respectively. The event-free survival in the observation group, control group 1, and control group 2 was 18.00, 9.82, and 24.90 months, respectively. The median survival time and the event-free survival in the control group 2 were significantly longer than those in the observation group and control group 1 ( χ2 = 19.93, 23.04, both P < 0.001). Conclusion:Chemotherapy combined with sorafenib for treating newly-diagnosed FLT3-ITD-positive acute myeloid leukemia can provide comprehensive benefits and have advantages for survival over chemotherapy without sorafenib and chemotherapy alone.