阿扎胞苷联合PD-1单抗治疗老年高危骨髓增生异常综合征或急性髓系白血病4例报告及文献复习

杨辰; 叶芳; 张岩; 张怡堃; 韩冰

doi:10.13201/j.issn.1004-2806.2021.01.013

阿扎胞苷联合PD-1单抗治疗老年高危骨髓增生异常综合征或急性髓系白血病4例报告及文献复习

- 1. 北京协和医院血液科(北京, 100730);
- 2. 北京垂杨柳医院血液科;
- 3. 北京隆福医院血液科;
- 4. 战略支援部队特色医学中心血液科
基金项目:
北京自然科学基金(No:7192168)

中国医学科学院医学创新基金(No:2016-I2M-3-004)

中国医学科学院中央级公益性科研院所基本科研业务费专项基金资助(No:2019XK320047)

详细信息

通讯作者: 韩冰,E-mail:hanbing_li@sina.com.cn

中图分类号: R733.7

收稿日期: 2020-08-11

Azacytidine combined with PD-1 antibody in the treatment of elderly high-risk myelodysplastic syndrome or acute myeloid leukemia:four cases report and literature review

More Information

Corresponding author: HAN Bing, E-mail: hanbing_li@sina.com.cn

Received Date: 11 August 2020

摘要

摘要: 骨髓增生异常综合征（myelodysplastic syndrome,MDS）和急性髓系白血病（acute myeloid leukemia,AML）均为起源于造血干细胞的髓系肿瘤,是老年人常见的恶性血液病[1-2]。随着世界人口的老龄化进展,近年来,MDS或老年AML的发生率显著升高,严重影响老年人的健康。由于老年MDS/AML患者临床状态较差、伴随疾病较多、器官功能及代偿能力不足,很难耐受强化治疗或干细胞移植,导致生存期缩短。去甲基化药物（hypomethylating agents,HMA）治疗的出现,给这些患者带来了希望。
- 骨髓增生异常综合征 /
- 急性髓系白血病 /
- 阿扎胞苷 /
- PD-1单抗 /
- 信迪利单抗 /
- 疗效
Abstract: To evaluate the efficacy and safety of azacitidine in combination with PD-1 antibody(sintilimab) in elderly patients with high risk myelodysplastic syndrome(HR-MDS) or acute myeloid leukemia(AML), we reported four cases of elderly patients with HR-MDS or AML treated with azacitidine in combination of PD-1 antibody and reviewed the related literature. For the four patients, 2 cases were males and 2 cases were females, and their median age was 75(71 to 83) years old. Two cases were refractory HR-MDS and the others were newly diagnosed AML. Three patients were transfusion dependent before treatment. Azacitidine was administered at 75 mg/m² for 7 days, and PD-1 antibody was given at 200 mg on d8. The median treatment cycle was 4.5(2 to 6) and the median time to response was 2(1 to 2) months. All patients had achieved CR/CRi, with improvement of the hematological parameters. The median follow-up was 6(3 to 10) months and the median time for progression free survival was 4.5(3 to 6.5) months. The main adverse events were infections caused by myelosuppression which could be improved after intensive supportive care and anti-infection therapy. One patient lost response due to the delay of treatment and one patient died of hemorrhage due to the possible colon cancer. Azacitidine in combination with PD-1 antibody provides a possible effective way of treating patients with HR-MDS or AML with acceptable adverse events, which merit further prospective investigation.
- myelodysplastic syndrome /
- acute myeloid leukemia /
- azacitidine /
- sintilimab /
- PD-1inhibitor /
- effect

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参考文献(14)

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