Venetoclax combined therapy in 8 patients with refractory/relapsed acute myeloid leukemia and literature review
-
摘要: 目的:评价短疗程Venetoclax(VEN)联合小剂量阿糖胞苷(ara-C)方案在难治/复发急性髓系白血病(AML)患者中的疗效和安全性。方法:报告8例以短疗程VEN+小剂量ara-C方案联合治疗的难治/复发AML患者。VEN使用剂量为200~400 mg QD口服,ara-C 10 mg/m2 Q12 h皮下注射,每疗程用药时间10~14 d。结果:8例患者初始治疗后3例达完全缓解,2例达部分缓解,3例评估为未缓解。治疗过程中发现幼稚单核细胞逐渐增多。发生的不良反应主要是3~4级血液学不良反应。结论:短疗程VEN联合小剂量ara-C方案治疗难治/复发AML患者有较好的有效率和安全性,但对急性单核细胞白血病疗效不佳。
-
关键词:
- Venetoclax /
- 小剂量阿糖胞苷 /
- 难治/复发急性髓系白血病
Abstract: Objective:To evaluate the efficacy and safety of short course venetoclax(VEN)combined with low dose cytarabine(ara-C)in patients with refractory or relapsed acute myeloid leukemia(AML).Methods:A report was performed among 8 patients with refractory or relapsed AML treated with short course VEN combination low dose ara-C.VEN was given at 200 to 400 mg orally every day,and ara-C was 10 mg/m2 subcutaneous injection every 12 hours. There were 10 to 14 days for each course of treatment.Results:After initial treatment,3 cases achieved complete response,2 case achieved partial response,and 3 cases had no response.In the course of treatment,we observed that the number of naive monocytes increased.The main adverse events were grade 3 to 4 hematological adverse events.Conclusion:Short course VEN combined with low dose ara-C regimen is effective and safe in the treatment of refractory or relapsed AML patients,but not effective in acute monocytic leukemia. -
-
[1] 张之南,沈悌.血液病诊断及疗效标准[M].3版.北京:科学出版社,2007:131-133.
[2] Aldoss I,Yang D,Aribi A,et al.Efficacy of the combination of venetoclax and hypomethylating agents in relapsed/refractory acute myeloid leukemia[J].Haematologica,2018,103(9):e404-e407.
[3] 李军民.老年急性髓系白血病患者的治疗策略[J].临床血液学杂志,2019,32(5):327-331.
[4] Wang YW,Tsai CH,Lin CC,et al.Cytogenetics and mutations could predict outcome in relapsed and refractory acute myeloid leukemia patients receiving BCL-2 inhibitor venetoclax[J].Ann Hematol,2020,99(3):501-511.
[5] Yalniz F,Abou Dalle I,Kantarjian H,et al.Prognostic significance of baseline FLT3-ITD mutant allele level in acute myeloid leukemia treated with intensive chemotherapy with/without sorafenib[J].Am J Hematol,2019,94(9):984-991.
[6] Boddu P,Takahashi K,Pemmaraju N,et al.Influence of IDH on FLT3/ITD status in newly diagnosed AML[J].Leukemia,2017,31(11):2526-2529.
[7] Souers AJ,Leverson JD,Boghaert ER,et al.ABT-199,a potent and selective Bcl-2 inhibitor,achieves antitumor activity while sparing platelets[J].Nat Med,2013,19(2):202-208.
[8] DiNardo CD,Pratz K,Pullarkat V,et al.Venetoclax combined with decitabine or azacitidine in treatment-naive,elderly patients with acute myeloid leukemia[J].Blood,2019,133(1):7-17.
[9] Bose P,Vachhani P,Cortes JE.Treatment of Relapsed/Refractory Acute Myeloid Leukemia[J].Curr Treat Options Oncol,2017,18(3):17.
[10] Liu B,Narurkar R,Hanmantgad M,et al.Venetoclax and low dose cytarabine induced complete remission in a patient with high risk acute myeloid leukemia:a case report[J].Front Med,2018,12(5):593-599.
[11] DiNardo CD,Rausch CR,Benton C,et al.Clinical experience with the BCL2-inhibitor venetoclax in combination therapy for relapsed and refractory acute myeloid leukemia and related myeloid malignancies[J].Am J Hematol,2018,93(3):401-407.
[12] Gaut D,Burkenroad A,Duong T,et al.Venetoclax combination therapy in relapsed/refractory acute myeloid leukemia:A single institution experience[J].Leuka Res,2020,90:106314.
[13] Pei S,Pollyea DA,Gustafson A,et al.Monocytic Subclones Confer Resistance to Venetoclax Based Therapy in Patients with Acute Myeloid Leukemia[J].Cancer Discov,2020,10(4):536-551.
-
计量
- 文章访问数: 530
- PDF下载数: 335
- 施引文献: 0
下载: